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NPI Code Detail

MEDICARE: MRS. RENEE GAYDOS MS, CCC/SLP

MEDICARE: MRS. RENEE GAYDOS MS, 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
1235Z00000XSpeech-Language PathologistSL003970LPA

General Provider Information

NPI Number : 1932681608
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RENEE GAYDOS MS, CCC/SLP
Provider Business Mailing Address
First Line : 685 ANGELA DR
Second Line :
City : GREENSBURG
State : PA
Zip : 15601-2688
Country : US
Telephone Number : 724-837-6070
Fax Number : 724-837-2181
Provider Business Practice Location Address
First Line : 685 ANGELA DR
Second Line :
City : GREENSBURG
State : PA
Zip : 15601-2655
Country : US
Telephone Number : 724-837-6070
Fax Number : 724-837-2181
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2018
Last Update Date : 08/30/2018

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