MEDICARE: NANCY LOUISE TARSHIS CCC-SLP

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	007493	NY

General Provider Information

NPI Number	:	1912033614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY LOUISE TARSHIS CCC-SLP

Provider Business Mailing Address
First Line	:	309 W 104TH ST
Second Line	:	APARTMENT 7C
City	:	NEW YORK
State	:	NY
Zip	:	10025-4135
Country	:	US
Telephone Number	:	718-430-3902
Fax Number	:

Provider Business Practice Location Address
First Line	:	1165 MORRIS PARK AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1915
Country	:	US
Telephone Number	:	718-430-3902
Fax Number	:	718-430-3989

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

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	07/08/2007

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Directions to “ NANCY LOUISE TARSHIS CCC-SLP” Practice Location

Language	Start Address	Practice Location

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