MEDICARE: MS. MAGALIS MORALES-GUZMAN 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	235Z00000X	Speech-Language Pathologist	008322-1	NY

General Provider Information

NPI Number	:	1346388188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MAGALIS MORALES-GUZMAN SLP

Provider Business Mailing Address
First Line	:	7922 265TH ST
Second Line	:
City	:	FLORAL PARK
State	:	NY
Zip	:	11004-1323
Country	:	US
Telephone Number	:	718-770-7732
Fax Number	:	866-378-3341

Provider Business Practice Location Address
First Line	:	8416 JAMAICA AVE
Second Line	:
City	:	WOODHAVEN
State	:	NY
Zip	:	11421-1920
Country	:	US
Telephone Number	:	718-277-2784
Fax Number	:	866-378-3341

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

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	09/07/2011

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