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NPI Code Detail

MEDICARE: MS. SHELLY DORON MS-CCC-SLP

MEDICARE: MS. SHELLY DORON 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
1235Z00000XSpeech-Language Pathologist025974-1NY

General Provider Information

NPI Number : 1205379864
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHELLY DORON MS-CCC-SLP
Provider Business Mailing Address
First Line : 51 SAINT EDWARDS ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11205-2932
Country : US
Telephone Number : 718-834-6756
Fax Number :
Provider Business Practice Location Address
First Line : 51 SAINT EDWARDS ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11205-2932
Country : US
Telephone Number : 718-834-6756
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2016
Last Update Date : 11/29/2016

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