MEDICARE: CRISTINA FOX

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	:	1821421298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTINA FOX

Provider Business Mailing Address
First Line	:	147 MITCHELL AVE
Second Line	:	APARTMENT 1
City	:	LONG BEACH
State	:	NY
Zip	:	11561-3819
Country	:	US
Telephone Number	:	516-578-6361
Fax Number	:

Provider Business Practice Location Address
First Line	:	52 CHAMBERS ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10007-1222
Country	:	US
Telephone Number	:	718-935-2000
Fax Number	:

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

Provider Enumeration Date	:	08/20/2013
Last Update Date	:	12/09/2016

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Directions to “ CRISTINA FOX ” Practice Location

Language	Start Address	Practice Location

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