MEDICARE: UNIVERSAL SPEECH, LLC

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

General Provider Information

NPI Number	:	1316423866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSAL SPEECH, LLC

Provider Business Mailing Address
First Line	:	2532 HUBBARD ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-6223
Country	:	US
Telephone Number	:	718-769-4170
Fax Number	:

Provider Business Practice Location Address
First Line	:	2532 HUBBARD ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-6223
Country	:	US
Telephone Number	:	646-269-3028
Fax Number	:

Authorized Official
Title or Position	:	SLP
Name	:	MAYA KATZ
Credential	:	MS, CCC-SLP BI TSSLD
Telephone Number	:	646-269-3028

Provider Enumeration Date	:	07/18/2018
Last Update Date	:	07/18/2018

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