MEDICARE: AMANDA GRACE NARVAEZ M.A. CCC-SLP, TSSLD

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	030296	NY

General Provider Information

NPI Number	:	1699322131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA GRACE NARVAEZ M.A. CCC-SLP, TSSLD

Provider Business Mailing Address
First Line	:	7 MARS RD
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-5031
Country	:	US
Telephone Number	:	631-965-5514
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 HURON DR
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-5433
Country	:	US
Telephone Number	:	631-965-5514
Fax Number	:

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

Provider Enumeration Date	:	08/20/2019
Last Update Date	:	05/28/2026

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