MEDICARE: LAUREN SALLEY

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	1928173251	NY

General Provider Information

NPI Number	:	1285508663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN SALLEY

Provider Business Mailing Address
First Line	:	60 E 126TH ST APT 3
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-1659
Country	:	US
Telephone Number	:	203-822-1331
Fax Number	:

Provider Business Practice Location Address
First Line	:	2441 WALLACE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-9215
Country	:	US
Telephone Number	:	718-652-6090
Fax Number	:

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

Provider Enumeration Date	:	09/30/2025
Last Update Date	:	09/30/2025

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Directions to “ LAUREN SALLEY ” Practice Location

Language	Start Address	Practice Location

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