Healthcare Provider Details
I. General information
NPI: 1255572806
Provider Name (Legal Business Name): MAGALY MEVS-HAMMOND M.S-CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/11/2009
Last Update Date: 08/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3 PROSPECT TER
YONKERS NY
10705
US
IV. Provider business mailing address
402 E 154TH ST STE 1
BRONX NY
10455-1222
US
V. Phone/Fax
- Phone: 917-312-5553
- Fax: 718-860-6388
- Phone: 718-618-7535
- Fax: 718-618-7537
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 06225-1 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: