MEDICARE: MS. MELISSA M. DILLUVIO M.A. 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	017-603	NY

General Provider Information

NPI Number	:	1497062111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELISSA M. DILLUVIO M.A. CCC-SLP

Provider Business Mailing Address
First Line	:	281 9TH AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10001-5701
Country	:	US
Telephone Number	:	917-974-2245
Fax Number	:

Provider Business Practice Location Address
First Line	:	281 9TH AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10001-5701
Country	:	US
Telephone Number	:	917-974-2245
Fax Number	:

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

Provider Enumeration Date	:	09/01/2010
Last Update Date	:	12/06/2016

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