MEDICARE: SARA WISCHNITZER M.S. 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		NY

General Provider Information

NPI Number	:	1982903522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA WISCHNITZER M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	14111 70TH RD
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11367-1936
Country	:	US
Telephone Number	:	718-263-6210
Fax Number	:

Provider Business Practice Location Address
First Line	:	14111 70TH RD
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11367-1936
Country	:	US
Telephone Number	:	718-263-6210
Fax Number	:

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

Provider Enumeration Date	:	03/22/2011
Last Update Date	:	03/22/2011

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Directions to “ SARA WISCHNITZER M.S. CCC-SLP” Practice Location

Language	Start Address	Practice Location

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