MEDICARE: MRS. DANIELLE L KATZ-EGERT M,S., 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	0168851	NY

General Provider Information

NPI Number	:	1801198064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANIELLE L KATZ-EGERT M,S., SLP

Provider Business Mailing Address
First Line	:	1157 E 27TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-4620
Country	:	US
Telephone Number	:	718-541-6497
Fax Number	:

Provider Business Practice Location Address
First Line	:	849 39TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11232-3229
Country	:	US
Telephone Number	:	718-851-3300
Fax Number	:	718-972-0696

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

Provider Enumeration Date	:	11/22/2010
Last Update Date	:	11/22/2010

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