MEDICARE: PERELE MIRIAM STULMAN

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	015052	NY

General Provider Information

NPI Number	:	1619112950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PERELE MIRIAM STULMAN

Provider Business Mailing Address
First Line	:	1554 E 29TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1898
Country	:	US
Telephone Number	:	718-377-0247
Fax Number	:

Provider Business Practice Location Address
First Line	:	2164 RALPH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-5406
Country	:	US
Telephone Number	:	718-531-1800
Fax Number	:

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

Provider Enumeration Date	:	12/15/2008
Last Update Date	:	12/15/2008

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Directions to “ PERELE MIRIAM STULMAN ” Practice Location

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