MEDICARE: MISS DANIELLE E. LARGENT MS, 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	:	1750771838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS DANIELLE E. LARGENT MS, CF-SLP

Provider Business Mailing Address
First Line	:	95 WALL ST
Second Line	:	APT. 1105
City	:	NEW YORK
State	:	NY
Zip	:	10005-4201
Country	:	US
Telephone Number	:	248-310-1116
Fax Number	:

Provider Business Practice Location Address
First Line	:	95 WALL ST
Second Line	:	APT. 1105
City	:	NEW YORK
State	:	NY
Zip	:	10005-4201
Country	:	US
Telephone Number	:	248-310-1116
Fax Number	:

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

Provider Enumeration Date	:	01/28/2015
Last Update Date	:	01/28/2015

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Directions to “ MISS DANIELLE E. LARGENT MS, CF-SLP” Practice Location

Language	Start Address	Practice Location

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