MEDICARE: HELENA PERETS 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
1	235Z00000X	Speech-Language Pathologist	013785	NY

General Provider Information

NPI Number	:	1689882276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HELENA PERETS SLP

Provider Business Mailing Address
First Line	:	3847 POPLAR AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-1301
Country	:	US
Telephone Number	:	718-449-0503
Fax Number	:	718-449-0503

Provider Business Practice Location Address
First Line	:	3847 POPLAR AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-1301
Country	:	US
Telephone Number	:	718-449-0503
Fax Number	:	718-449-0503

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

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	04/27/2009

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Directions to “ HELENA PERETS SLP” Practice Location

Language	Start Address	Practice Location

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