MEDICARE: PIGI'S WORLD

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	261QH0700X	Hearing and Speech Clinic/Center	020354	NY

General Provider Information

NPI Number	:	1366787491
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIGI'S WORLD

Provider Business Mailing Address
First Line	:	1120 BRIGHTON BEACH AVE APT 1C
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5519
Country	:	US
Telephone Number	:	347-866-9817
Fax Number	:

Provider Business Practice Location Address
First Line	:	1120 BRIGHTON BEACH AVE APT 1C
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5519
Country	:	US
Telephone Number	:	347-866-9817
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LYNN ROSENBERG
Credential	:	MS-SLP, TSSLD
Telephone Number	:	347-866-9817

Provider Enumeration Date	:	11/29/2012
Last Update Date	:	11/29/2012

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Directions to “PIGI'S WORLD ” Practice Location

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