MEDICARE: MR. ASTON J ROSENBERG CF-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	6659	SC

General Provider Information

NPI Number	:	1487136180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ASTON J ROSENBERG CF-SLP

Provider Business Mailing Address
First Line	:	1022 COMET CREEK LN
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29486-8047
Country	:	US
Telephone Number	:	479-420-6840
Fax Number	:

Provider Business Practice Location Address
First Line	:	4362 LESLIE ST
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29418
Country	:	US
Telephone Number	:	843-323-0174
Fax Number	:

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

Provider Enumeration Date	:	08/30/2018
Last Update Date	:	08/30/2018

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Directions to “ MR. ASTON J ROSENBERG CF-SLP” Practice Location

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