MEDICARE: SARA BRUSCHI

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	024743	NY

General Provider Information

NPI Number	:	1871960492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA BRUSCHI

Provider Business Mailing Address
First Line	:	6719 EXETER ST
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-4149
Country	:	US
Telephone Number	:	803-984-4930
Fax Number	:

Provider Business Practice Location Address
First Line	:	6719 EXETER ST
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-4149
Country	:	US
Telephone Number	:	803-984-4930
Fax Number	:

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

Provider Enumeration Date	:	08/31/2015
Last Update Date	:	08/31/2015

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Directions to “ SARA BRUSCHI ” Practice Location

Language	Start Address	Practice Location

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