MEDICARE: MS. ALISA NAOMI STEIN M.S. SLP-CF

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		NY

General Provider Information

NPI Number	:	1326486051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALISA NAOMI STEIN M.S. SLP-CF

Provider Business Mailing Address
First Line	:	1755 YORK AVE
Second Line	:	APARTMENT 26E
City	:	NEW YORK
State	:	NY
Zip	:	10128-6849
Country	:	US
Telephone Number	:	510-684-7501
Fax Number	:

Provider Business Practice Location Address
First Line	:	1755 YORK AVE
Second Line	:	APARTMENT 26E
City	:	NEW YORK
State	:	NY
Zip	:	10128-6849
Country	:	US
Telephone Number	:	510-684-7501
Fax Number	:

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

Provider Enumeration Date	:	06/04/2013
Last Update Date	:	06/04/2013

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