MEDICARE: SLR SERVICES INC

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	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1740764711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLR SERVICES INC

Provider Business Mailing Address
First Line	:	216 SYCAMORE ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-5616
Country	:	US
Telephone Number	:	347-570-5828
Fax Number	:

Provider Business Practice Location Address
First Line	:	216 SYCAMORE ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-5616
Country	:	US
Telephone Number	:	347-570-5828
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LIDIYA STOROZINSKY
Credential	:	MSED
Telephone Number	:	347-570-5828

Provider Enumeration Date	:	09/17/2018
Last Update Date	:	09/20/2018

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Directions to “SLR SERVICES INC ” Practice Location

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