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NPI Code Detail

MEDICARE: MRS. KRISTINE ANNE ANDUX MACCC-SLP

MEDICARE: MRS. KRISTINE ANNE ANDUX MACCC-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 Pathologist012616-1NY

General Provider Information

NPI Number : 1568767580
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTINE ANNE ANDUX MACCC-SLP
Provider Business Mailing Address
First Line : 20 LOIS PL
Second Line :
City : VALLEY STREAM
State : NY
Zip : 11580-6027
Country : US
Telephone Number : 516-770-2193
Fax Number :
Provider Business Practice Location Address
First Line : 10 LAKE DR
Second Line :
City : MANHASSET HILLS
State : NY
Zip : 11040-1123
Country : US
Telephone Number : 516-627-6391
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2011
Last Update Date : 01/23/2011

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Directions to “ MRS. KRISTINE ANNE ANDUX MACCC-SLP” Practice Location

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