Kimberly Ann Wissel | Staten Island, NY • PECOS Search

Kimberly Ann Wissel

Speech-Language Pathologist

Speech, Language and Hearing Service Providers

81 Renee Pl, Staten Island, NY 10314-3324

PECOS Enrollment

Based on the most recent information from CMS, provider Kimberly Ann Wissel does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1134356363
Provider Type
Individual
Full Name
Wissel, Kimberly Ann
Title
Mrs.
Credential
M.A. CCC/SLP

Gender
Female
Sole Proprietor
No
Enumeration Date
6/15/2009
Last Updated
6/15/2009

Contact Information

Practice Location

81 Renee Pl, Staten Island, NY 10314-3324

Unlisted Fax

Mailing Location

81 Renee Pl, Staten Island, NY 10314-3324

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 235Z00000X Primary	Description Speech-Language Pathologist Speech, Language and Hearing Service Providers	License 013272 New York