Individual ProviderDeepa JohnSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address472 Livermore Ave, Staten Island, NY 10314-2178(347) 850-5048PECOS EnrollmentBased on the most recent information from CMS, provider Deepa John 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 ID1851696124Provider TypeIndividualFull NameJohn, DeepaGenderFemaleSole ProprietorYesEnumeration Date1/18/2011Last Updated1/18/2011Contact InformationPractice LocationPractice Address472 Livermore Ave, Staten Island, NY 10314-2178Phone(347) 850-5048FaxUnlisted FaxMailing LocationMailing Address472 Livermore Ave, Staten Island, NY 10314-2178Phone(347) 850-5048FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicenseUnlisted Issuer