1255654356 NPI number — MRS. ELLEN KALODNER ISDANER MA,SLP,CCC

Table of content: MRS. ELLEN KALODNER ISDANER MA,SLP,CCC (NPI 1255654356)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255654356 NPI number — MRS. ELLEN KALODNER ISDANER MA,SLP,CCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ISDANER
Provider First Name:
ELLEN
Provider Middle Name:
KALODNER
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MA,SLP,CCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255654356
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
357 WYNDMOOR LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGDON VALLEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-938-1939
Provider Business Mailing Address Fax Number:
215-938-7192

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3300 TOWNSHIP LINE ROAD
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
DREXEL HILL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19026-1925
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-853-9919
Provider Business Practice Location Address Fax Number:
610-853-9921
Provider Enumeration Date:
03/04/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SL000174L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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