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NPI Code Detail

MEDICARE: MRS. SHONA JOHN TSSLD, MA-CCC, SLP

MEDICARE: MRS. SHONA JOHN TSSLD, MA-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
1235Z00000XSpeech-Language Pathologist016785NY

General Provider Information

NPI Number : 1790019321
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHONA JOHN TSSLD, MA-CCC, SLP
Provider Business Mailing Address
First Line : 475 E 57TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11203-6010
Country : US
Telephone Number : 718-451-5213
Fax Number :
Provider Business Practice Location Address
First Line : 475 E 57TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11203-6010
Country : US
Telephone Number : 171-845-1521
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2009
Last Update Date : 07/07/2022

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Directions to “ MRS. SHONA JOHN TSSLD, MA-CCC, SLP” Practice Location

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