MEDICARE: SAMANTHA HAYLEY COTUGNO M.S., 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	020204	NY

General Provider Information

NPI Number	:	1700195492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA HAYLEY COTUGNO M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	2515 WILLIAMS CT.
Second Line	:
City	:	BELLMORE
State	:	NY
Zip	:	11710-4804
Country	:	US
Telephone Number	:	516-458-6464
Fax Number	:

Provider Business Practice Location Address
First Line	:	670 PARKSIDE AVE.
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-1506
Country	:	US
Telephone Number	:	718-675-1249
Fax Number	:

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

Provider Enumeration Date	:	09/29/2010
Last Update Date	:	08/14/2012

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