MEDICARE: ELITE COMMUNICATIONS, LLC: DAMALI ROBINSON, 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
1	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1194965400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE COMMUNICATIONS, LLC: DAMALI ROBINSON, MS-CCC-SLP

Provider Business Mailing Address
First Line	:	195 WILLOUGHBY AVE
Second Line	:	SUITE NUMBER 609
City	:	BROOKLYN
State	:	NY
Zip	:	11205-3843
Country	:	US
Telephone Number	:	917-743-2110
Fax Number	:

Provider Business Practice Location Address
First Line	:	195 WILLOUGHBY AVE
Second Line	:	SUITE NUMBER 609
City	:	BROOKLYN
State	:	NY
Zip	:	11205-3843
Country	:	US
Telephone Number	:	917-743-2110
Fax Number	:

Authorized Official
Title or Position	:	SPEECH PATHOLOGIST
Name	:	DAMALI K ROBINSON
Credential	:	MS-CCC-SLP
Telephone Number	:	917-743-2110

Provider Enumeration Date	:	02/26/2009
Last Update Date	:	02/26/2009

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