MEDICARE: MISS KELLY MCGLYN MACCCSLP

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	013876	NY

General Provider Information

NPI Number	:	1821243437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KELLY MCGLYN MACCCSLP

Provider Business Mailing Address
First Line	:	446 BEMENT AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10310-2128
Country	:	US
Telephone Number	:	917-577-6790
Fax Number	:

Provider Business Practice Location Address
First Line	:	446 BEMENT AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10310-2128
Country	:	US
Telephone Number	:	917-577-6790
Fax Number	:

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

Provider Enumeration Date	:	11/24/2008
Last Update Date	:	06/16/2015

Similar Medicare Providers

1356763007 — MS. LORETTA ANN RAIOLA I MASTERS DEGREE IN ED
Practice Location Address:

430 BEMENT AVE
STATEN ISLAND, NY
10310-2128

Practice Phone: 718-816-4159
Practice Fax:

1336905678 — CASSANDRA WILLIAMS LGPC, CSC-AD
Practice Location Address:

10310 POPES CREEK RD
NEWBURG, MD
20664-2128

Practice Phone: 240-444-6186
Practice Fax:

1588939367 — MRS. MARY K NAIR R N
Practice Location Address:

1860 FOREST AVE
STATEN ISLAND, NY
10303-2128

Practice Phone: 718-442-2219
Practice Fax:

1144870346 — KELLY LYNN CUTUGNO MA, CCC-SLP
Practice Location Address:

1860 FOREST AVE
STATEN ISLAND, NY
10303-2128

Practice Phone: 718-442-2219
Practice Fax:

1891339560 — MR. CARMINE ANTHONY LACERTOSA M.S., CF-SLP, TSSLD
Practice Location Address:

1860 FOREST AVE
STATEN ISLAND, NY
10303-2128

Practice Phone: 718-442-2219
Practice Fax:

1144819673 — MR. ANDREW JAMES FAIRLEY CRPA
Practice Location Address:

96 MOBILE AVE
STATEN ISLAND, NY
10306-2128

Practice Phone: 347-756-0787
Practice Fax:

Directions to “ MISS KELLY MCGLYN MACCCSLP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.