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NPI Code Detail

MEDICARE: NICOLE CESTRO MS, CCC-SLP

MEDICARE: NICOLE CESTRO MS, 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 Pathologist027990NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396261400
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE CESTRO MS, CCC-SLP
Provider Business Mailing Address
First Line : 2565 HARVARD LN
Second Line :
City : SEAFORD
State : NY
Zip : 11783-3528
Country : US
Telephone Number : 516-554-1065
Fax Number :
Provider Business Practice Location Address
First Line : 1225 FRANKLIN AVE STE 325
Second Line :
City : GARDEN CITY
State : NY
Zip : 11530-1693
Country : US
Telephone Number : 516-512-8905
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2017
Last Update Date : 03/10/2021

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