MEDICARE: MS. MICHELLE REBECCA CURCHACK 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	020093-1	NY

General Provider Information

NPI Number	:	1700174877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE REBECCA CURCHACK CCC-SLP

Provider Business Mailing Address
First Line	:	104 W 70TH ST
Second Line	:	4A
City	:	NEW YORK
State	:	NY
Zip	:	10023-4454
Country	:	US
Telephone Number	:	516-578-8380
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 ARTHUR DR
Second Line	:
City	:	EAST ROCKAWAY
State	:	NY
Zip	:	11518-2128
Country	:	US
Telephone Number	:	516-578-8380
Fax Number	:

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

Provider Enumeration Date	:	07/11/2011
Last Update Date	:	01/09/2017

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