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NPI Code Detail

MEDICARE: KATHRYN ROSE TARNER MA CCC-SLP

MEDICARE: KATHRYN ROSE TARNER MA 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 Pathologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144500240
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN ROSE TARNER MA CCC-SLP
Provider Business Mailing Address
First Line : 40 VAN ARSDALE PL
Second Line :
City : MANHASSET
State : NY
Zip : 11030-2257
Country : US
Telephone Number : 516-313-9240
Fax Number :
Provider Business Practice Location Address
First Line : 2420 PARSONS BLVD
Second Line :
City : WHITESTONE
State : NY
Zip : 11357-3444
Country : US
Telephone Number : 718-469-6279
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2011
Last Update Date : 06/29/2022

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