MEDICARE: SHIRA FARKAS M.S. 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	018085	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033598990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIRA FARKAS M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	18 YOUMANS DR
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-2513
Country	:	US
Telephone Number	:	845-262-1254
Fax Number	:

Provider Business Practice Location Address
First Line	:	18 YOUMANS DR
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-2513
Country	:	US
Telephone Number	:	845-262-1254
Fax Number	:

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

Provider Enumeration Date	:	05/26/2015
Last Update Date	:	05/26/2015

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