MEDICARE: MS. ROSE EGUINO

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	003742-1	NY

General Provider Information

NPI Number	:	1558548313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROSE EGUINO

Provider Business Mailing Address
First Line	:	3086 GIEGERICH PL
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10465-4010
Country	:	US
Telephone Number	:	347-293-8247
Fax Number	:

Provider Business Practice Location Address
First Line	:	3086 GIEGERICH PL
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10465-4010
Country	:	US
Telephone Number	:	347-293-8247
Fax Number	:

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

Provider Enumeration Date	:	01/23/2008
Last Update Date	:	01/23/2008

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Directions to “ MS. ROSE EGUINO ” Practice Location

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