MEDICARE: SERIOUSLY SPEAKING LLC

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	235Z00000X	Speech-Language Pathologist	014367-1	NY

General Provider Information

NPI Number	:	1245667500
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERIOUSLY SPEAKING LLC

Provider Business Mailing Address
First Line	:	14121 70TH RD
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11367-1936
Country	:	US
Telephone Number	:	718-261-7110
Fax Number	:

Provider Business Practice Location Address
First Line	:	14121 70TH RD
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11367-1936
Country	:	US
Telephone Number	:	718-261-7110
Fax Number	:

Authorized Official
Title or Position	:	SPEECH THERAPIST
Name	:	SARA BECKER
Credential	:	MA CCC SLP
Telephone Number	:	917-689-3171

Provider Enumeration Date	:	10/02/2013
Last Update Date	:	10/02/2013

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Directions to “SERIOUSLY SPEAKING LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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