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NPI Code Detail

MEDICARE: AIDEL MINTZ

MEDICARE: AIDEL MINTZ
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 : 1194006015
Entity Type Code : Individual
Provider Name (Legal Business Name) : AIDEL MINTZ
Provider Business Mailing Address
First Line : 1733 44TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11204-1051
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3321 AVENUE M
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-5421
Country : US
Telephone Number : 718-531-1800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2011
Last Update Date : 09/06/2011

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Directions to “ AIDEL MINTZ ” Practice Location

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