MEDICARE: MS. VICTORIA LORENZO-KUZNIK M.A., 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	017643	NY

General Provider Information

NPI Number	:	1982848917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VICTORIA LORENZO-KUZNIK M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	5601 RIVERDALE AVE
Second Line	:	4L
City	:	BRONX
State	:	NY
Zip	:	10471-2119
Country	:	US
Telephone Number	:	917-497-8614
Fax Number	:	718-884-0433

Provider Business Practice Location Address
First Line	:	5601 RIVERDALE AVE
Second Line	:	4L
City	:	BRONX
State	:	NY
Zip	:	10471-2119
Country	:	US
Telephone Number	:	917-497-8614
Fax Number	:	718-884-0433

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

Provider Enumeration Date	:	04/21/2009
Last Update Date	:	04/21/2009

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