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NPI Code Detail

MEDICARE: MS. NICOLE LOPERENA CCC-SLP

MEDICARE: MS. NICOLE LOPERENA 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 Pathologist020794NY

General Provider Information

NPI Number : 1205107307
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NICOLE LOPERENA CCC-SLP
Provider Business Mailing Address
First Line : 500 19TH STREET
Second Line : K280
City : BROOKLYN
State : NY
Zip : 11215
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 500 19TH ST
Second Line : K280
City : BROOKLYN
State : NY
Zip : 11215-6204
Country : US
Telephone Number : 718-369-4450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2012
Last Update Date : 11/30/2016

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Directions to “ MS. NICOLE LOPERENA CCC-SLP” Practice Location

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