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NPI Code Detail

MEDICARE: ZINA P. FAYACHE MA, MS, SLP

MEDICARE: ZINA P. FAYACHE MA, MS, 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 Pathologist000933-1NY

General Provider Information

NPI Number : 1063656031
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZINA P. FAYACHE MA, MS, SLP
Provider Business Mailing Address
First Line : 190 1ST ST
Second Line : APARTMENT 3-H
City : MINEOLA
State : NY
Zip : 11501-4011
Country : US
Telephone Number : 516-883-0552
Fax Number : 516-883-0552
Provider Business Practice Location Address
First Line : 10 LAKE DR
Second Line : NSSLA
City : MANHASSET HILLS
State : NY
Zip : 11040-1123
Country : US
Telephone Number : 516-627-6391
Fax Number : 516-627-2057
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2009
Last Update Date : 04/21/2009

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