MEDICARE: GRISEL PIZARRO

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	235Z0000X	NY

General Provider Information

NPI Number	:	1336550391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRISEL PIZARRO

Provider Business Mailing Address
First Line	:	1345 5TH AVENUE APT. 12B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029
Country	:	US
Telephone Number	:	646-409-0094
Fax Number	:

Provider Business Practice Location Address
First Line	:	1345 5TH AVE APT 12B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-1024
Country	:	US
Telephone Number	:	646-409-0094
Fax Number	:

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

Provider Enumeration Date	:	05/13/2014
Last Update Date	:	05/13/2014

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Directions to “ GRISEL PIZARRO ” Practice Location

Language	Start Address	Practice Location

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