Andrea Marie Rethorn | Staten Island, NY • PECOS Search

Andrea Marie Rethorn

Speech-Language Pathologist

Speech, Language and Hearing Service Providers

147 Rice Ave, Staten Island, NY 10314-3029

PECOS Enrollment

Based on the most recent information from CMS, provider Andrea Marie Rethorn 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
1588808430
Provider Type
Individual
Full Name
Rethorn, Andrea Marie
Title
Mrs.
Credential
M.S., CCC-SLP

Gender
Female
Sole Proprietor
Yes
Enumeration Date
4/22/2009
Last Updated
4/22/2009

Contact Information

Practice Location

147 Rice Ave, Staten Island, NY 10314-3029

Unlisted Fax

Mailing Location

147 Rice Ave, Staten Island, NY 10314-3029

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 235Z00000X Primary	Description Speech-Language Pathologist Speech, Language and Hearing Service Providers	License 015309 New York