MEDICARE: DEBBI YEDVARB

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
1	235Z00000X	Speech-Language Pathologist	015896	NY

General Provider Information

NPI Number	:	1134430945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBBI YEDVARB

Provider Business Mailing Address
First Line	:	76 STONEHURST LN
Second Line	:
City	:	DIX HILLS
State	:	NY
Zip	:	11746-7934
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4951 CHAMBERS STREET
Second Line	:	6TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10007-1209
Country	:	US
Telephone Number	:	631-431-3232
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2010
Last Update Date	:	06/25/2010

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Directions to “ DEBBI YEDVARB ” Practice Location

Language	Start Address	Practice Location

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