MEDICARE: MISS KAITLIN PATRICIA MCVEIGH M.A., SLP-TSSLD

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	025865	NY

General Provider Information

NPI Number	:	1295278083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KAITLIN PATRICIA MCVEIGH M.A., SLP-TSSLD

Provider Business Mailing Address
First Line	:	235 BEACH 135TH ST
Second Line	:
City	:	BELLE HARBOR
State	:	NY
Zip	:	11694-1305
Country	:	US
Telephone Number	:	646-296-2582
Fax Number	:

Provider Business Practice Location Address
First Line	:	330 59TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3718
Country	:	US
Telephone Number	:	718-492-0087
Fax Number	:

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

Provider Enumeration Date	:	11/28/2016
Last Update Date	:	11/28/2016

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