MEDICARE: MS. KATRINA ANDRES

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

General Provider Information

NPI Number	:	1730501412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATRINA ANDRES

Provider Business Mailing Address
First Line	:	319 AVENUE C
Second Line	:	APT 9C
City	:	NEW YORK
State	:	NY
Zip	:	10009-1618
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	319 AVENUE C
Second Line	:	APT 9C
City	:	NEW YORK
State	:	NY
Zip	:	10009-1618
Country	:	US
Telephone Number	:	415-310-4144
Fax Number	:

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

Provider Enumeration Date	:	01/14/2014
Last Update Date	:	01/14/2014

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Directions to “ MS. KATRINA ANDRES ” Practice Location

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