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NPI Code Detail

MEDICARE: MRS. AMANDA ZELAYA CCC-LSLP

MEDICARE:  MRS. AMANDA  ZELAYA  CCC-LSLP
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 Pathologist023706NY

General Provider Information

NPI Number : 1962862243
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMANDA ZELAYA CCC-LSLP
Provider Business Mailing Address
First Line : 132 WOODIN RD
Second Line :
City : HALFMOON
State : NY
Zip : 12065-6135
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 79 102ND ST
Second Line :
City : TROY
State : NY
Zip : 12180-1125
Country : US
Telephone Number : 518-273-6600
Fax Number : 518-273-9567
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2016
Last Update Date : 03/01/2016

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Directions to “ MRS. AMANDA ZELAYA CCC-LSLP” Practice Location

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