MEDICARE: MRS. SVETLANA KAZ MS, CCC-SLP, TSHH

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	012007-1	NY

General Provider Information

NPI Number	:	1881828119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SVETLANA KAZ MS, CCC-SLP, TSHH

Provider Business Mailing Address
First Line	:	521 AVENUE Y
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-6035
Country	:	US
Telephone Number	:	191-764-7339
Fax Number	:

Provider Business Practice Location Address
First Line	:	521 AVENUE Y
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-6035
Country	:	US
Telephone Number	:	917-647-3393
Fax Number	:

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

Provider Enumeration Date	:	05/14/2009
Last Update Date	:	05/14/2009

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