Individual ProviderAmanda Van TassellSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address243 Demorest Ave, Staten Island, NY 10314-3160(347) 884-0120PECOS EnrollmentBased on the most recent information from CMS, provider Amanda Van Tassell 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 ID1952919706Provider TypeIndividualFull NameVan Tassell, AmandaCredentialM.S., CF-SLPGenderFemaleSole ProprietorNoEnumeration Date7/17/2020Last Updated7/17/2020Contact InformationPractice LocationPractice Address243 Demorest Ave, Staten Island, NY 10314-3160Phone(347) 884-0120FaxUnlisted FaxMailing LocationMailing Address243 Demorest Ave, Staten Island, NY 10314-3160Phone(347) 884-0120FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicenseUnlisted Issuer