MEDICARE: MRS. SHEILA SEALY MA/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	235Z00000X	Speech-Language Pathologist	007328	NY

General Provider Information

NPI Number	:	1346474210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHEILA SEALY MA/CCC-SLP

Provider Business Mailing Address
First Line	:	8 MEADOWFARM LN
Second Line	:
City	:	COLD SPRING HARBOR
State	:	NY
Zip	:	11724-2004
Country	:	US
Telephone Number	:	631-659-3299
Fax Number	:	631-425-1513

Provider Business Practice Location Address
First Line	:	8 MEADOWFARM LN
Second Line	:
City	:	COLD SPRING HARBOR
State	:	NY
Zip	:	11724-2004
Country	:	US
Telephone Number	:	631-659-3299
Fax Number	:	631-425-1513

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

Provider Enumeration Date	:	05/07/2009
Last Update Date	:	05/07/2009

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