MEDICARE: REBECCA KRAWIECZ

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	01590-1	NY

General Provider Information

NPI Number	:	1396057709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA KRAWIECZ

Provider Business Mailing Address
First Line	:	2120 NEW YORK AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-5424
Country	:	US
Telephone Number	:	917-226-7313
Fax Number	:	718-258-8721

Provider Business Practice Location Address
First Line	:	2120 NEW YORK AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-5424
Country	:	US
Telephone Number	:	917-226-7313
Fax Number	:	718-258-8721

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

Provider Enumeration Date	:	07/14/2010
Last Update Date	:	07/14/2010

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Directions to “ REBECCA KRAWIECZ ” Practice Location

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