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NPI Code Detail

MEDICARE: KASEY ANN ROBERTSON

MEDICARE: KASEY ANN ROBERTSON
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 Pathologist

General Provider Information

NPI Number : 1093377632
Entity Type Code : Individual
Provider Name (Legal Business Name) : KASEY ANN ROBERTSON
Provider Business Mailing Address
First Line : 31 BEACH 222ND ST
Second Line :
City : BREEZY POINT
State : NY
Zip : 11697-1502
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15801 CROSSBAY BLVD
Second Line :
City : HOWARD BEACH
State : NY
Zip : 11414-3140
Country : US
Telephone Number : 718-848-0875
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2019
Last Update Date : 07/03/2019

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Directions to “ KASEY ANN ROBERTSON ” Practice Location

Language Start Address Practice Location
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