MEDICARE: MRS. SVETLANA BELOPOLSKY 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
1	235Z00000X	Speech-Language Pathologist	016710	NY

General Provider Information

NPI Number	:	1013121250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SVETLANA BELOPOLSKY SLP

Provider Business Mailing Address
First Line	:	2356 E 73RD ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-6622
Country	:	US
Telephone Number	:	347-538-6488
Fax Number	:

Provider Business Practice Location Address
First Line	:	2356 E 73RD ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-6622
Country	:	US
Telephone Number	:	347-538-6488
Fax Number	:

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

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	07/28/2010

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