MEDICARE: LAURA FOGERTY M.S., CF-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

General Provider Information

NPI Number	:	1578974200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA FOGERTY M.S., CF-SLP

Provider Business Mailing Address
First Line	:	72 CLINTON PL
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02459-1141
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	999 BROADWAY
Second Line	:
City	:	SAUGUS
State	:	MA
Zip	:	01906-4521
Country	:	US
Telephone Number	:	781-558-9565
Fax Number	:

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

Provider Enumeration Date	:	05/15/2014
Last Update Date	:	05/15/2014

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Directions to “ LAURA FOGERTY M.S., CF-SLP” Practice Location

Language	Start Address	Practice Location

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