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General NPI Number Information
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NPI Number | 1396258927
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Entity Type | Organization
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Legal Business Name | MBS SPEECH-LANGUAGE PATHOLOGIST PC
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Dates
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Enumeration Date | 11/06/2017
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Last Update Date | 11/06/2017
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Provider Practice Location Address
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Address Line | 98 FIRST ST
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City | YONKERS
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State | NY
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Zip | 10704-4370
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Country | US
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Telephone | 646-220-2451
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Fax |
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Provider Business Mailing Address
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Address Line | 98 FIRST ST
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City | YONKERS
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State | NY
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Zip | 10704-4370
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Country | US
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Telephone | 646-220-2451
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | MADELINE VARGAS
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Credential | M.A, CCC-SLP
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Telephone | 646-220-2451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 013850-1
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License Number State | NY
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