Individual ProviderAndrea NicolosiSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address202 Burr Rd, Commack, NY 11725-1810(631) 858-3636PECOS EnrollmentBased on the most recent information from CMS, provider Andrea Nicolosi does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1063814390Provider TypeIndividualFull NameNicolosi, AndreaGenderFemaleSole ProprietorYesEnumeration Date9/18/2014Last Updated9/18/2014Contact InformationPractice LocationPractice Address202 Burr Rd, Commack, NY 11725-1810Phone(631) 858-3636FaxUnlisted FaxMailing LocationMailing Address202 Burr Rd, Commack, NY 11725-1810Phone(631) 858-3636FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense014050New York