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NPI Code Detail

MEDICARE: MRS. BRIDGET NIEVES M.A.,CCC-SLP/TSSLD

MEDICARE: MRS. BRIDGET NIEVES M.A.,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
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1093948952
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRIDGET NIEVES M.A.,CCC-SLP/TSSLD
Provider Business Mailing Address
First Line : 5 DAKOTA DR
Second Line :
City : NEW HYDE PARK
State : NY
Zip : 11042-1107
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5 DAKOTA DR
Second Line :
City : NEW HYDE PARK
State : NY
Zip : 11042-1107
Country : US
Telephone Number : 718-281-8515
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2009
Last Update Date : 02/10/2014

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Directions to “ MRS. BRIDGET NIEVES M.A.,CCC-SLP/TSSLD” Practice Location

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