MEDICARE: ALYONA SLIOZBERG 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	016118-1	NY

General Provider Information

NPI Number	:	1457509184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYONA SLIOZBERG CCC-SLP

Provider Business Mailing Address
First Line	:	6735 YELLOWSTONE BLVD
Second Line	:	4S
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-2669
Country	:	US
Telephone Number	:	718-554-3474
Fax Number	:

Provider Business Practice Location Address
First Line	:	6735 YELLOWSTONE BLVD
Second Line	:	4S
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-2669
Country	:	US
Telephone Number	:	718-554-3474
Fax Number	:

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

Provider Enumeration Date	:	09/06/2008
Last Update Date	:	09/06/2008

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