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NPI Code Detail

MEDICARE: NIQUETTE DESTIN SPEECH-LANGUAGE PATH

MEDICARE: NIQUETTE DESTIN SPEECH-LANGUAGE PATH
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
1103T00000XPsychologist
21041C0700XClinical Social Worker
3235Z00000XSpeech-Language Pathologist
4235Z00000XSpeech-Language Pathologist016079-1NY

General Provider Information

NPI Number : 1801026547
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIQUETTE DESTIN SPEECH-LANGUAGE PATH
Provider Business Mailing Address
First Line : 22004 LINDEN BLVD
Second Line :
City : CAMBRIA HEIGHTS
State : NY
Zip : 11411-1621
Country : US
Telephone Number : 718-712-3358
Fax Number : 888-352-0588
Provider Business Practice Location Address
First Line : 22004 LINDEN BLVD
Second Line :
City : CAMBRIA HEIGHTS
State : NY
Zip : 11411-1621
Country : US
Telephone Number : 718-712-3358
Fax Number : 718-712-3379
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2009
Last Update Date : 10/05/2018

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Directions to “ NIQUETTE DESTIN SPEECH-LANGUAGE PATH” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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