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NPI Code Detail

MEDICARE: RAISA GINZBURG SLP

MEDICARE: RAISA GINZBURG 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 Pathologist017853NY

General Provider Information

NPI Number : 1326367210
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAISA GINZBURG SLP
Provider Business Mailing Address
First Line : 36 HAMILTON AVE APT 4A
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10301-1820
Country : US
Telephone Number : 718-448-5668
Fax Number :
Provider Business Practice Location Address
First Line : 475 SEAVIEW AVE
Second Line : STATEN ISLAND UNIVERSITY HOSPITAL
City : STATEN ISLAND
State : NY
Zip : 10305-3436
Country : US
Telephone Number : 718-226-8276
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2010
Last Update Date : 07/15/2010

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Directions to “ RAISA GINZBURG SLP” Practice Location

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