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NPI Code Detail

MEDICARE: MRS. OKSANA NEKTALOVA MA CCC SLP

MEDICARE: MRS. OKSANA NEKTALOVA MA CCC SLP
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
1235Z00000XSpeech-Language Pathologist018993NY

General Provider Information

NPI Number : 1548697303
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. OKSANA NEKTALOVA MA CCC SLP
Provider Business Mailing Address
First Line : 7507 171ST ST
Second Line :
City : FRESH MEADOWS
State : NY
Zip : 11366-1416
Country : US
Telephone Number : 646-369-4673
Fax Number :
Provider Business Practice Location Address
First Line : 18302 UNION TPKE
Second Line :
City : FLUSHING
State : NY
Zip : 11366-1623
Country : US
Telephone Number : 718-969-3944
Fax Number : 718-969-4073
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2013
Last Update Date : 10/10/2013

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