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NPI Code Detail

MEDICARE: EMILY TODD MONTEFUSCO M.S. CCC-SLP

MEDICARE: EMILY TODD MONTEFUSCO M.S. 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
1235Z00000XSpeech-Language Pathologist019296-1NY
2235Z00000XSpeech-Language Pathologist10661NC

General Provider Information

NPI Number : 1558672519
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY TODD MONTEFUSCO M.S. CCC-SLP
Provider Business Mailing Address
First Line : 749 NINTH ST APT 118
Second Line :
City : DURHAM
State : NC
Zip : 27705-4802
Country : US
Telephone Number : 631-848-9571
Fax Number :
Provider Business Practice Location Address
First Line : 3905 UNIVERSITY DR
Second Line :
City : DURHAM
State : NC
Zip : 27707-2517
Country : US
Telephone Number : 919-928-0204
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2010
Last Update Date : 08/11/2014

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Directions to “ EMILY TODD MONTEFUSCO M.S. CCC-SLP” Practice Location

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