MEDICARE: BREE ALLISON ROSEMAN 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
1	235Z00000X	Speech-Language Pathologist	018832-1	NY

General Provider Information

NPI Number	:	1770721672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BREE ALLISON ROSEMAN M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	400 E 71ST ST
Second Line	:	22N
City	:	NEW YORK
State	:	NY
Zip	:	10021-4808
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 E 71ST ST
Second Line	:	22N
City	:	NEW YORK
State	:	NY
Zip	:	10021-4808
Country	:	US
Telephone Number	:	516-578-5330
Fax Number	:

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

Provider Enumeration Date	:	01/30/2009
Last Update Date	:	07/18/2011

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