MEDICARE: LETS TALK 123 SLP PC

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

General Provider Information

NPI Number	:	1376053827
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LETS TALK 123 SLP PC

Provider Business Mailing Address
First Line	:	67-35 YELLOWSTONE BLVD
Second Line	:	4S
City	:	FOREST HILLS
State	:	NY
Zip	:	11375
Country	:	US
Telephone Number	:	646-334-3249
Fax Number	:

Provider Business Practice Location Address
First Line	:	6735 YELLOWSTONE BLVD
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-2669
Country	:	US
Telephone Number	:	646-334-3249
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALYONA SLIOZBERG
Credential	:	CCC SLP
Telephone Number	:	646-334-3249

Provider Enumeration Date	:	10/10/2017
Last Update Date	:	10/10/2017

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Directions to “LETS TALK 123 SLP PC ” Practice Location

Language	Start Address	Practice Location

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