MEDICARE: BRIGITTE S DELAROSA 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
1	235Z00000X	Speech-Language Pathologist	030407	NY

General Provider Information

NPI Number	:	1407443302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIGITTE S DELAROSA CCC-SLP

Provider Business Mailing Address
First Line	:	50 RIVERDALE AVE APT 5A
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10701-3640
Country	:	US
Telephone Number	:	914-433-9116
Fax Number	:

Provider Business Practice Location Address
First Line	:	535 UNION AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10455-4649
Country	:	US
Telephone Number	:	718-292-4120
Fax Number	:

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

Provider Enumeration Date	:	12/26/2020
Last Update Date	:	12/26/2020

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Directions to “ BRIGITTE S DELAROSA CCC-SLP” Practice Location

Language	Start Address	Practice Location

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