MEDICARE: MR. NEIL C STRAUSS MS CCC-A

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	231H00000X	Audiologist	001592-1	NY

General Provider Information

NPI Number	:	1386705325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NEIL C STRAUSS MS CCC-A

Provider Business Mailing Address
First Line	:	10440 QUEENS BLVD
Second Line	:	#1C
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-3637
Country	:	US
Telephone Number	:	718-841-7487
Fax Number	:	718-841-7487

Provider Business Practice Location Address
First Line	:	10440 QUEENS BLVD
Second Line	:	#1C
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-3637
Country	:	US
Telephone Number	:	718-841-7487
Fax Number	:	718-841-7487

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

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	09/13/2011

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