MEDICARE: STELLA K LORMAN MS CCC SLP PC

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	0115861	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700198314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STELLA K LORMAN MS CCC SLP PC

Provider Business Mailing Address
First Line	:	1479 ROYCE ST
Second Line	:	SUITE #3A
City	:	BROOKLYN
State	:	NY
Zip	:	11234-5823
Country	:	US
Telephone Number	:	516-204-6921
Fax Number	:

Provider Business Practice Location Address
First Line	:	2554 E 65TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-6927
Country	:	US
Telephone Number	:	516-204-6921
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. STELLA K LORMAN
Credential	:	MS CCC SLP
Telephone Number	:	516-204-6921

Provider Enumeration Date	:	07/12/2010
Last Update Date	:	08/25/2014

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