MEDICARE: HOPE'S PLACE SPEECH LANGUAGE PATHOLOGY SERVICES, P.C.

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	251E00000X	Home Health Agency	010829	NY

General Provider Information

NPI Number	:	1033422787
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE'S PLACE SPEECH LANGUAGE PATHOLOGY SERVICES, P.C.

Provider Business Mailing Address
First Line	:	145 BIRCH DR
Second Line	:
City	:	MANHASSET HILLS
State	:	NY
Zip	:	11040-2321
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 BIRCH DR
Second Line	:
City	:	MANHASSET HILLS
State	:	NY
Zip	:	11040-2321
Country	:	US
Telephone Number	:	516-877-1544
Fax Number	:

Authorized Official
Title or Position	:	CLINIC DIRECTOR
Name	:	MRS. NADIA MARKOVIC
Credential	:	MA, CCC-SLP
Telephone Number	:	516-877-1544

Provider Enumeration Date	:	07/23/2010
Last Update Date	:	07/23/2010

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