MEDICARE: MRS. BEATA GRAZYNA CONTRI M.S. CCC-A

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	231H00000X	Audiologist	002060	NY

General Provider Information

NPI Number	:	1679762116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BEATA GRAZYNA CONTRI M.S. CCC-A

Provider Business Mailing Address
First Line	:	1887 RICHMOND AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3923
Country	:	US
Telephone Number	:	718-370-0072
Fax Number	:	718-370-6733

Provider Business Practice Location Address
First Line	:	1887 RICHMOND AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3923
Country	:	US
Telephone Number	:	718-370-0072
Fax Number	:	718-370-6733

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

Provider Enumeration Date	:	10/22/2007
Last Update Date	:	01/06/2009

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