MEDICARE: MR. ARUNAS JONAS CIUBERKIS 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
1	235Z00000X	Speech-Language Pathologist	3557-1	NY

General Provider Information

NPI Number	:	1699912741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ARUNAS JONAS CIUBERKIS CCC, SLP

Provider Business Mailing Address
First Line	:	105 BUTLER ST APT 1F
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11231-4778
Country	:	US
Telephone Number	:	718-935-0053
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 BUTLER ST APT 1F
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11231-4778
Country	:	US
Telephone Number	:	718-935-0053
Fax Number	:

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

Provider Enumeration Date	:	01/12/2009
Last Update Date	:	01/12/2009

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