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NPI Code Detail

MEDICARE: MRS. CHAMUNDEESWARI THIAGESWARAN MA CCC-SLP TSSH

MEDICARE: MRS. CHAMUNDEESWARI THIAGESWARAN MA CCC-SLP TSSH
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 Pathologist014090NY

General Provider Information

NPI Number : 1447405287
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHAMUNDEESWARI THIAGESWARAN MA CCC-SLP TSSH
Provider Business Mailing Address
First Line : 14424 37TH AVE APT 5M
Second Line :
City : FLUSHING
State : NY
Zip : 11354-5911
Country : US
Telephone Number : 917-363-5026
Fax Number :
Provider Business Practice Location Address
First Line : 1028 E 179TH ST
Second Line :
City : BRONX
State : NY
Zip : 10460-2222
Country : US
Telephone Number : 718-842-0200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2008
Last Update Date : 11/20/2008

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Directions to “ MRS. CHAMUNDEESWARI THIAGESWARAN MA CCC-SLP TSSH” Practice Location

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