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NPI Code Detail

MEDICARE: LISA ZARKADAS MA SLP TSHH

MEDICARE: LISA ZARKADAS MA SLP TSHH
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 Pathologist010478-1NY

General Provider Information

NPI Number : 1285778290
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA ZARKADAS MA SLP TSHH
Provider Business Mailing Address
First Line : 6 HARGROVE DR
Second Line :
City : STONY BROOK
State : NY
Zip : 11790-2306
Country : US
Telephone Number : 631-675-1632
Fax Number :
Provider Business Practice Location Address
First Line : 525 HALF HOLLOW RD
Second Line :
City : DIX HILLS
State : NY
Zip : 11746-5828
Country : US
Telephone Number : 631-592-3650
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2007
Last Update Date : 02/10/2011

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