MEDICARE: MRS. STELLA TSATSARONIS MS 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	034259	NY

General Provider Information

NPI Number	:	1942029632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STELLA TSATSARONIS MS CCC SLP

Provider Business Mailing Address
First Line	:	16608 69TH AVE
Second Line	:
City	:	FRESH MEADOWS
State	:	NY
Zip	:	11365-3246
Country	:	US
Telephone Number	:	917-900-6283
Fax Number	:

Provider Business Practice Location Address
First Line	:	2750 LAFAYETTE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10465-2299
Country	:	US
Telephone Number	:	917-900-6283
Fax Number	:

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

Provider Enumeration Date	:	10/09/2024
Last Update Date	:	10/09/2024

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