MEDICARE: MRS. URSZULA GLOGOWSKA 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	016788-1	NY

General Provider Information

NPI Number	:	1740507078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. URSZULA GLOGOWSKA CCC-SLP

Provider Business Mailing Address
First Line	:	100 BEEKMAN ST APT 15E
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10038-1816
Country	:	US
Telephone Number	:	212-406-9520
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 BEEKMAN ST APT 15E
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10038-1816
Country	:	US
Telephone Number	:	212-406-9520
Fax Number	:

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

Provider Enumeration Date	:	04/27/2010
Last Update Date	:	04/27/2010

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