MEDICARE: WOMENS LEAGUE

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	252Y00000X	Early Intervention Provider Agency	009851-1	NY

General Provider Information

NPI Number	:	1316182066
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOMENS LEAGUE

Provider Business Mailing Address
First Line	:	1282 E 31ST ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-4741
Country	:	US
Telephone Number	:	917-327-0314
Fax Number	:

Provider Business Practice Location Address
First Line	:	1282 E 31ST ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-4741
Country	:	US
Telephone Number	:	917-327-0314
Fax Number	:

Authorized Official
Title or Position	:	SPEECH/LANGUAGE PATHOLOGIST
Name	:	MRS. REEVA PLAUT
Credential	:	M.S., CCC/SLP-NYS-L
Telephone Number	:	917-327-0314

Provider Enumeration Date	:	12/10/2008
Last Update Date	:	12/10/2008

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Directions to “WOMENS LEAGUE ” Practice Location

Language	Start Address	Practice Location

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