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NPI Code Detail

MEDICARE: MRS. DEBBIE MAZAL SHARON-LISS MS CCC/SLP

MEDICARE: MRS. DEBBIE MAZAL SHARON-LISS MS CCC/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 Pathologist010528NY
2235Z00000XSpeech-Language Pathologist010528-1NY

General Provider Information

NPI Number : 1659518637
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEBBIE MAZAL SHARON-LISS MS CCC/SLP
Provider Business Mailing Address
First Line : 2136 E 63RD ST
Second Line : DEBBIE SHARON-LISS
City : BROOKLYN
State : NY
Zip : 11234-6302
Country : US
Telephone Number : 917-603-3551
Fax Number : 516-341-0563
Provider Business Practice Location Address
First Line : 3321 AVENUE M
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-5421
Country : US
Telephone Number : 917-603-3551
Fax Number : 516-341-0563
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2009
Last Update Date : 02/13/2014

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