MEDICARE: MAKING STRIDES SLP-PT-PLLC

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	174400000X	Specialist

General Provider Information

NPI Number	:	1609401710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAKING STRIDES SLP-PT-PLLC

Provider Business Mailing Address
First Line	:	805 36TH AVE
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-5117
Country	:	US
Telephone Number	:	516-238-1173
Fax Number	:

Provider Business Practice Location Address
First Line	:	805 36TH AVE
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-5117
Country	:	US
Telephone Number	:	516-238-1173
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. JOHN TSAROUHIS
Credential	:
Telephone Number	:	516-238-1173

Provider Enumeration Date	:	03/09/2020
Last Update Date	:	08/02/2022

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Directions to “MAKING STRIDES SLP-PT-PLLC ” Practice Location

Language	Start Address	Practice Location

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