MEDICARE: MS. ANGELIKA BREYCHER

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	1789593	NY

General Provider Information

NPI Number	:	1689980716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANGELIKA BREYCHER

Provider Business Mailing Address
First Line	:	545 NEPTUNE AVE APT 21B
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-4057
Country	:	US
Telephone Number	:	718-996-0338
Fax Number	:

Provider Business Practice Location Address
First Line	:	415 BEVERLEY RD
Second Line	:	UNIT LT
City	:	BROOKLYN
State	:	NY
Zip	:	11218-3153
Country	:	US
Telephone Number	:	718-972-6561
Fax Number	:

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

Provider Enumeration Date	:	08/26/2010
Last Update Date	:	08/26/2010

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