MEDICARE: ALEXANDRA KARLSON

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	:	1619345576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA KARLSON

Provider Business Mailing Address
First Line	:	3136 88TH ST
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11369-1415
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3136 88TH ST
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11369-1415
Country	:	US
Telephone Number	:	718-205-1919
Fax Number	:

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

Provider Enumeration Date	:	09/09/2015
Last Update Date	:	09/09/2015

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Directions to “ ALEXANDRA KARLSON ” Practice Location

Language	Start Address	Practice Location

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