MEDICARE: CARYN GOLOMBECK

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	019688	NY

General Provider Information

NPI Number	:	1013228444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARYN GOLOMBECK

Provider Business Mailing Address
First Line	:	10421 68TH DR
Second Line	:	APT. B15
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-3455
Country	:	US
Telephone Number	:	914-924-1715
Fax Number	:

Provider Business Practice Location Address
First Line	:	10421 68TH DR
Second Line	:	APT. B15
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-3455
Country	:	US
Telephone Number	:	914-924-1715
Fax Number	:

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

Provider Enumeration Date	:	06/30/2010
Last Update Date	:	06/30/2010

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Directions to “ CARYN GOLOMBECK ” Practice Location

Language	Start Address	Practice Location

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