MEDICARE: COMMUNIKARE SLP PLLC

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	:	1790035756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNIKARE SLP PLLC

Provider Business Mailing Address
First Line	:	6623 RIDGE BLVD APT 1C
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-4859
Country	:	US
Telephone Number	:	917-669-3200
Fax Number	:

Provider Business Practice Location Address
First Line	:	6623 RIDGE BLVD APT 1C
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-4859
Country	:	US
Telephone Number	:	917-669-3200
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ELINA ETIS
Credential	:	SLP
Telephone Number	:	917-669-3200

Provider Enumeration Date	:	09/17/2012
Last Update Date	:	09/17/2012

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