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NPI Code Detail

MEDICARE: MS. TARA P GREENE M.A., CCC-SLP

MEDICARE:  MS. TARA P GREENE  M.A., 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
1235Z00000XSpeech-Language Pathologist013461NY

General Provider Information

NPI Number : 1386187177
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TARA P GREENE M.A., CCC-SLP
Provider Business Mailing Address
First Line : 544 7TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11215-6140
Country : US
Telephone Number : 718-788-4482
Fax Number :
Provider Business Practice Location Address
First Line : 544 7TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11215-6140
Country : US
Telephone Number : 718-788-4482
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2016
Last Update Date : 11/28/2016

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Directions to “ MS. TARA P GREENE M.A., CCC-SLP” Practice Location

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