MEDICARE: TIYLAE BILLS

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

General Provider Information

NPI Number	:	1871349829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIYLAE BILLS

Provider Business Mailing Address
First Line	:	2 UNDERHILL RD APT F
Second Line	:
City	:	MIDDLETOWN
State	:	NY
Zip	:	10940-7028
Country	:	US
Telephone Number	:	347-572-1223
Fax Number	:

Provider Business Practice Location Address
First Line	:	59 WINDSOR HWY
Second Line	:
City	:	NEW WINDSOR
State	:	NY
Zip	:	12553-6233
Country	:	US
Telephone Number	:	845-485-9803
Fax Number	:

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

Provider Enumeration Date	:	04/29/2024
Last Update Date	:	05/02/2024

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Directions to “ TIYLAE BILLS ” Practice Location

Language	Start Address	Practice Location

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