MEDICARE: ARB SPEECH PATHOLOGY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	252Y00000X	Early Intervention Provider Agency	09843	NY

General Provider Information

NPI Number	:	1518195452
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARB SPEECH PATHOLOGY

Provider Business Mailing Address
First Line	:	2356 ROYCE ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-6616
Country	:	US
Telephone Number	:	917-709-1147
Fax Number	:	718-209-9629

Provider Business Practice Location Address
First Line	:	2356 ROYCE STREET
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-6616
Country	:	US
Telephone Number	:	917-709-1147
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. ANGELA BARBAROVICH
Credential	:	CCC-SLP
Telephone Number	:	917-709-1147

Provider Enumeration Date	:	06/30/2009
Last Update Date	:	06/30/2009

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