Individual ProviderEllana BrederSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address2221 Richmond Ave, Staten Island, NY 10314-3920(718) 475-5200(917) 939-9577PECOS EnrollmentBased on the most recent information from CMS, provider Ellana Breder 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 2 days ago.Profile DetailsProvider ID1154873982Provider TypeIndividualFull NameBreder, EllanaTitleMrs.CredentialM.A., CCC-SLPGenderFemaleSole ProprietorNoEnumeration Date10/27/2016Last Updated10/2/2020Contact InformationPractice LocationPractice Address2221 Richmond Ave, Staten Island, NY 10314-3920Phone(718) 475-5200FaxUnlisted FaxMailing LocationMailing Address24 Station Ave, Staten Island, NY 10309-2719Phone(917) 939-9577FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense025174-1New York