MEDICARE: MRS. VERONICA CEA 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
1	235Z00000X	Speech-Language Pathologist	013688-1	NY

General Provider Information

NPI Number	:	1578511259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VERONICA CEA M.S. CCC/SLP

Provider Business Mailing Address
First Line	:	7 SHORE RD
Second Line	:
City	:	STONY BROOK
State	:	NY
Zip	:	11790-1407
Country	:	US
Telephone Number	:	631-942-5209
Fax Number	:

Provider Business Practice Location Address
First Line	:	887 OLD COUNTRY RD
Second Line	:
City	:	RIVERHEAD
State	:	NY
Zip	:	11901-2115
Country	:	US
Telephone Number	:	631-591-3288
Fax Number	:	631-458-1681

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	09/25/2015

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Directions to “ MRS. VERONICA CEA M.S. CCC/SLP” Practice Location

Language	Start Address	Practice Location

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