MEDICARE: ALISBEL ZORRILLA 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	011692-1	NY

General Provider Information

NPI Number	:	1346784337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISBEL ZORRILLA SLP

Provider Business Mailing Address
First Line	:	23102 67TH AVE
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11364-2706
Country	:	US
Telephone Number	:	718-279-0096
Fax Number	:	718-352-7783

Provider Business Practice Location Address
First Line	:	23102 67TH AVE
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11364-2706
Country	:	US
Telephone Number	:	718-279-0096
Fax Number	:	718-352-7783

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

Provider Enumeration Date	:	12/09/2016
Last Update Date	:	12/09/2016

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Directions to “ ALISBEL ZORRILLA SLP” Practice Location

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