Lisa Beth Dickstein | Staten Island, NY • PECOS Search

Lisa Beth Dickstein

Speech-Language Pathologist

Speech, Language and Hearing Service Providers

54 Mulberry Cir, Staten Island, NY 10314-3716

PECOS Enrollment

Based on the most recent information from CMS, provider Lisa Beth Dickstein 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
1356578231
Provider Type
Individual
Full Name
Dickstein, Lisa Beth
Title
Ms.
Credential
MS CCC SLP

Gender
Female
Sole Proprietor
Yes
Enumeration Date
6/17/2009
Last Updated
6/17/2009

Contact Information

Practice Location

54 Mulberry Cir, Staten Island, NY 10314-3716

Unlisted Fax

Mailing Location

54 Mulberry Cir, Staten Island, NY 10314-3716

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 235Z00000X Primary	Description Speech-Language Pathologist Speech, Language and Hearing Service Providers	License 004936-1 New York