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NPI Code Detail

MEDICARE: ANNE MENDELSON MIRMAN-TYSER SLP

MEDICARE: ANNE MENDELSON MIRMAN-TYSER 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
1235Z00000XSpeech-Language PathologistSP1464OH

Other Identifiers

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

General Provider Information

NPI Number : 1629275185
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNE MENDELSON MIRMAN-TYSER SLP
Provider Business Mailing Address
First Line : 6283 RUTHERFORD PL
Second Line :
City : COLUMBUS
State : OH
Zip : 43213-3439
Country : US
Telephone Number : 614-866-6654
Fax Number :
Provider Business Practice Location Address
First Line : 5500 E BROAD ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43213-1476
Country : US
Telephone Number : 614-575-9003
Fax Number : 614-575-9101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2007
Last Update Date : 07/08/2007

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Directions to “ ANNE MENDELSON MIRMAN-TYSER SLP” Practice Location

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