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NPI Code Detail

MEDICARE: MISS MAUREEN TERESA ESCOBAR M.A., CCC/SLP

MEDICARE: MISS MAUREEN TERESA ESCOBAR M.A., 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 Pathologist016971NY

General Provider Information

NPI Number : 1730327941
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MAUREEN TERESA ESCOBAR M.A., CCC/SLP
Provider Business Mailing Address
First Line : 25 WILLIS AVE
Second Line :
City : RONKONKOMA
State : NY
Zip : 11779-4152
Country : US
Telephone Number : 631-806-3752
Fax Number :
Provider Business Practice Location Address
First Line : 1 SCOUTING BLVD
Second Line :
City : MEDFORD
State : NY
Zip : 11763-2220
Country : US
Telephone Number : 631-297-3204
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2009
Last Update Date : 11/08/2018

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Directions to “ MISS MAUREEN TERESA ESCOBAR M.A., CCC/SLP” Practice Location

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