MEDICARE: VICKI H KORMAN 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
1	235500000X	Speech/Language/Hearing Specialist/Technologist	010578	NY
2	235Z00000X	Speech-Language Pathologist	010578	NY

General Provider Information

NPI Number	:	1326283714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICKI H KORMAN CCC/SLP

Provider Business Mailing Address
First Line	:	8 EVERGREEN CT
Second Line	:
City	:	MONTEBELLO
State	:	NY
Zip	:	10901-3507
Country	:	US
Telephone Number	:	917-859-9522
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 EVERGREEN CT
Second Line	:
City	:	MONTEBELLO
State	:	NY
Zip	:	10901-3507
Country	:	US
Telephone Number	:	917-859-9522
Fax Number	:

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

Provider Enumeration Date	:	12/12/2008
Last Update Date	:	01/07/2025

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