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NPI Code Detail

MEDICARE: MS. CHRISTINE ANN VANDERMEID SLP

MEDICARE: MS. CHRISTINE ANN VANDERMEID 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
1235Z00000XSpeech-Language Pathologist4630-1NY

General Provider Information

NPI Number : 1053696492
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHRISTINE ANN VANDERMEID SLP
Provider Business Mailing Address
First Line : 31 BRYAN ST
Second Line :
City : ROCHESTER
State : NY
Zip : 14613-1714
Country : US
Telephone Number : 585-254-3110
Fax Number :
Provider Business Practice Location Address
First Line : 31 BRYAN ST
Second Line :
City : ROCHESTER
State : NY
Zip : 14613-1714
Country : US
Telephone Number : 585-254-3110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2011
Last Update Date : 10/17/2011

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