MEDICARE: MRS. IRINA BELAU MS 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	011267	NY

General Provider Information

NPI Number	:	1730322801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. IRINA BELAU MS CCC-SLP

Provider Business Mailing Address
First Line	:	1875 W 7TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-2639
Country	:	US
Telephone Number	:	347-768-0220
Fax Number	:	718-645-0065

Provider Business Practice Location Address
First Line	:	1875 W 7TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-2639
Country	:	US
Telephone Number	:	347-768-0220
Fax Number	:	718-645-0065

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

Provider Enumeration Date	:	04/19/2009
Last Update Date	:	04/19/2009

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