MEDICARE: REBECCA METZGER M.S., CCC-SLP, TSSLD

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	023060-1	NY

General Provider Information

NPI Number	:	1053668186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA METZGER M.S., CCC-SLP, TSSLD

Provider Business Mailing Address
First Line	:	180 RIVERSIDE BLVD APT 17D
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10069-0812
Country	:	US
Telephone Number	:	732-996-7212
Fax Number	:

Provider Business Practice Location Address
First Line	:	39 W 14TH ST STE 505
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10011-7403
Country	:	US
Telephone Number	:	917-518-9904
Fax Number	:

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

Provider Enumeration Date	:	08/08/2012
Last Update Date	:	03/20/2018

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Directions to “ REBECCA METZGER M.S., CCC-SLP, TSSLD” Practice Location

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