MEDICARE: MRS. JUDY C KAHN

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	015863-1	NY

General Provider Information

NPI Number	:	1932432408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JUDY C KAHN

Provider Business Mailing Address
First Line	:	3122 AVENUE L
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-4739
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3122 AVENUE L
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-4739
Country	:	US
Telephone Number	:	718-252-0190
Fax Number	:

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

Provider Enumeration Date	:	09/15/2009
Last Update Date	:	09/15/2009

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Directions to “ MRS. JUDY C KAHN ” Practice Location

Language	Start Address	Practice Location

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