MEDICARE: ARIANA RACHEL SHUSHAN 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	032634-01	NY

General Provider Information

NPI Number	:	1366143406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIANA RACHEL SHUSHAN SLP

Provider Business Mailing Address
First Line	:	10225 67TH DR APT 4B
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-2861
Country	:	US
Telephone Number	:	347-455-5118
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 TELLER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10456-6182
Country	:	US
Telephone Number	:	347-455-5118
Fax Number	:

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

Provider Enumeration Date	:	03/15/2023
Last Update Date	:	03/15/2023

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Directions to “ ARIANA RACHEL SHUSHAN SLP” Practice Location

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