MEDICARE: TAMAR MAZAL BERGER GASKO CF-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
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1568204402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMAR MAZAL BERGER GASKO CF-SLP

Provider Business Mailing Address
First Line	:	1125 W VIRGINIA AVE NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-3815
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1125 W VIRGINIA AVE NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-3815
Country	:	US
Telephone Number	:	240-507-4419
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2024
Last Update Date	:	06/11/2024

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Directions to “ TAMAR MAZAL BERGER GASKO CF-SLP” Practice Location

Language	Start Address	Practice Location

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