MEDICARE: MRS. KARLI ANN NEGRIN MPT

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	010001046	DE
2	235Z00000X	Speech-Language Pathologist	O10001046	NJ

General Provider Information

NPI Number	:	1962685586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KARLI ANN NEGRIN MPT

Provider Business Mailing Address
First Line	:	PO BOX 191
Second Line	:
City	:	ROCKLAND
State	:	DE
Zip	:	19732-0191
Country	:	US
Telephone Number	:	302-651-4000
Fax Number	:	302-651-4945

Provider Business Practice Location Address
First Line	:	443 LAUREL OAK RD
Second Line	:
City	:	VOORHEES
State	:	NJ
Zip	:	08043-4419
Country	:	US
Telephone Number	:	856-309-8508
Fax Number	:	856-309-8556

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

Provider Enumeration Date	:	12/06/2007
Last Update Date	:	11/19/2013

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