MEDICARE: GO SLP,P.C.

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	018149	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609270990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GO SLP,P.C.

Provider Business Mailing Address
First Line	:	1122 PELHAM PKWY S
Second Line	:	2
City	:	BRONX
State	:	NY
Zip	:	10461-1027
Country	:	US
Telephone Number	:	917-517-6349
Fax Number	:

Provider Business Practice Location Address
First Line	:	1122 PELHAM PKWY S
Second Line	:	2
City	:	BRONX
State	:	NY
Zip	:	10461-1027
Country	:	US
Telephone Number	:	917-517-6349
Fax Number	:

Authorized Official
Title or Position	:	SPEECH LANGUAGE PATHOLOGIST
Name	:	OKSANA GALCHINSKAYA
Credential	:	MA, CCC-SLP
Telephone Number	:	917-517-6349

Provider Enumeration Date	:	10/15/2014
Last Update Date	:	10/15/2014

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Directions to “GO SLP,P.C. ” Practice Location

Language	Start Address	Practice Location

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