MEDICARE: CARMEN MILAGROS QUINONES M.S, 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	017894	NY

General Provider Information

NPI Number	:	1962730861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMEN MILAGROS QUINONES M.S, SLP

Provider Business Mailing Address
First Line	:	2007 HOBART AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-3916
Country	:	US
Telephone Number	:	347-880-7322
Fax Number	:	347-621-5257

Provider Business Practice Location Address
First Line	:	2007 HOBART AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-3916
Country	:	US
Telephone Number	:	347-880-7322
Fax Number	:	347-621-5257

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

Provider Enumeration Date	:	12/03/2009
Last Update Date	:	12/03/2009

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