MEDICARE: MISS TOVA CHAYA LEIBOWITZ M.S.

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	58 022475	NY

General Provider Information

NPI Number	:	1265871883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS TOVA CHAYA LEIBOWITZ M.S.

Provider Business Mailing Address
First Line	:	14735 76TH AVE APT 1D
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11367-3103
Country	:	US
Telephone Number	:	347-374-1241
Fax Number	:

Provider Business Practice Location Address
First Line	:	7515 MAIN ST
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11367-2420
Country	:	US
Telephone Number	:	718-263-5437
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2013
Last Update Date	:	06/17/2013

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Directions to “ MISS TOVA CHAYA LEIBOWITZ M.S.” Practice Location

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