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NPI Code Detail

MEDICARE: MRS. REBECCA GROSSMAN MA, CCC-SLP

MEDICARE: MRS. REBECCA GROSSMAN MA, CCC-SLP
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 Pathologist007576-1NY

General Provider Information

NPI Number : 1316183270
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REBECCA GROSSMAN MA, CCC-SLP
Provider Business Mailing Address
First Line : 311 FOREST AVE
Second Line :
City : WOODMERE
State : NY
Zip : 11598-2919
Country : US
Telephone Number : 516-295-3395
Fax Number :
Provider Business Practice Location Address
First Line : 311 FOREST AVE
Second Line :
City : WOODMERE
State : NY
Zip : 11598-2919
Country : US
Telephone Number : 516-295-3395
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/24/2008
Last Update Date : 12/24/2008

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Directions to “ MRS. REBECCA GROSSMAN MA, CCC-SLP” Practice Location

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