MEDICARE: ZINAIDA GILYAYEVA MA, SLP CCC

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	019186	NY

General Provider Information

NPI Number	:	1821227307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZINAIDA GILYAYEVA MA, SLP CCC

Provider Business Mailing Address
First Line	:	14225 PERSHING CRES APT 4K
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11435-2034
Country	:	US
Telephone Number	:	347-279-0463
Fax Number	:

Provider Business Practice Location Address
First Line	:	14225 PERSHING CRES APT 4K
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11435-2034
Country	:	US
Telephone Number	:	347-279-0463
Fax Number	:

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

Provider Enumeration Date	:	07/06/2009
Last Update Date	:	09/24/2010

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