MEDICARE: MISS YANA REBECCA PLESHIVOY CCC-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	019185	NY

General Provider Information

NPI Number	:	1033341623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS YANA REBECCA PLESHIVOY CCC-SLP

Provider Business Mailing Address
First Line	:	2451 38TH ST
Second Line	:	APT 5D
City	:	ASTORIA
State	:	NY
Zip	:	11103-4138
Country	:	US
Telephone Number	:	646-643-2196
Fax Number	:

Provider Business Practice Location Address
First Line	:	3636 33RD ST
Second Line	:	SUITE 500
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-2329
Country	:	US
Telephone Number	:	212-529-9780
Fax Number	:

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

Provider Enumeration Date	:	08/14/2009
Last Update Date	:	08/14/2009

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