MEDICARE: VICTORIIA AYBINDER MACCCSLP

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

General Provider Information

NPI Number	:	1518099100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIIA AYBINDER MACCCSLP

Provider Business Mailing Address
First Line	:	3767 RICHMOND AVE
Second Line	:	2ND FLOOR
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-3827
Country	:	US
Telephone Number	:	718-967-0359
Fax Number	:	718-967-0394

Provider Business Practice Location Address
First Line	:	3767 RICHMOND AVE
Second Line	:	2ND FLOOR
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-3827
Country	:	US
Telephone Number	:	718-967-0359
Fax Number	:	718-967-0394

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

Provider Enumeration Date	:	03/10/2007
Last Update Date	:	07/08/2007

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Directions to “ VICTORIIA AYBINDER MACCCSLP” Practice Location

Language	Start Address	Practice Location

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