MEDICARE: MS. MONIKA M HEATH

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	020218	NY

General Provider Information

NPI Number	:	1932412921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MONIKA M HEATH

Provider Business Mailing Address
First Line	:	512 CLARK ST
Second Line	:	APT 3
City	:	WAVERLY
State	:	NY
Zip	:	14892-1054
Country	:	US
Telephone Number	:	607-372-3611
Fax Number	:

Provider Business Practice Location Address
First Line	:	409 RIVERSIDE AVE
Second Line	:
City	:	ELMIRA
State	:	NY
Zip	:	14904-1519
Country	:	US
Telephone Number	:	607-735-3850
Fax Number	:

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

Provider Enumeration Date	:	07/19/2010
Last Update Date	:	07/19/2010

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Directions to “ MS. MONIKA M HEATH ” Practice Location

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