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NPI Code Detail

MEDICARE: MS. LISA MARIE DREWSKI MS CCC-SLP

MEDICARE: MS. LISA MARIE DREWSKI MS CCC-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 Pathologist017463NY

General Provider Information

NPI Number : 1104078922
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LISA MARIE DREWSKI MS CCC-SLP
Provider Business Mailing Address
First Line : 2060 BRIGHTON HENRIETTA TOWN LINE RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14623-2792
Country : US
Telephone Number : 585-271-0661
Fax Number : 585-244-2871
Provider Business Practice Location Address
First Line : 2060 BRIGHTON HENRIETTA TOWN LINE RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14623-2792
Country : US
Telephone Number : 585-271-0661
Fax Number : 585-244-2871
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2008
Last Update Date : 12/15/2010

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