MEDICARE: CHANAH BARBANEL

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	018275	NY

General Provider Information

NPI Number	:	1851835664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANAH BARBANEL

Provider Business Mailing Address
First Line	:	10855 69TH AVE
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-3854
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10855 69TH AVE
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-3854
Country	:	US
Telephone Number	:	718-459-1358
Fax Number	:

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

Provider Enumeration Date	:	12/13/2016
Last Update Date	:	12/13/2016

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Directions to “ CHANAH BARBANEL ” Practice Location

Language	Start Address	Practice Location

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