MEDICARE: MS. JUDITH RACHEL NEMZER 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	000707-1	NY

General Provider Information

NPI Number	:	1538313119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JUDITH RACHEL NEMZER M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	7711 35TH AVENUE
Second Line	:	4K
City	:	JACKSON HEIGHTS
State	:	NEW YORK
Zip	:	11372
Country	:	UM
Telephone Number	:	718-424-4145
Fax Number	:	718-424-4145

Provider Business Practice Location Address
First Line	:	7711 35TH AVENUE
Second Line	:	4K
City	:	JACKSON HEIGHTS
State	:	NEW YORK
Zip	:	11372
Country	:	UM
Telephone Number	:	718-424-4145
Fax Number	:	718-424-4145

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

Provider Enumeration Date	:	11/10/2008
Last Update Date	:	11/10/2008

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