Individual ProviderMichelle GottliebSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address623 Ingram Ave, Staten Island, NY 10314-4366(732) 266-4589PECOS EnrollmentBased on the most recent information from CMS, provider Michelle Gottlieb 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 ID1265768204Provider TypeIndividualFull NameGottlieb, MichelleCredentialMA CCC-SLPGenderFemaleSole ProprietorYesEnumeration Date10/27/2009Last Updated10/27/2009Contact InformationPractice LocationPractice Address623 Ingram Ave, Staten Island, NY 10314-4366Phone(732) 266-4589FaxUnlisted FaxMailing LocationMailing Address623 Ingram Ave, Staten Island, NY 10314-4366Phone(732) 266-4589FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense016514-1New York