1609100551 NPI number — NORTH JERSEY VOICE SPEECH AND SWALLOW CENTER LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609100551 NPI number — NORTH JERSEY VOICE SPEECH AND SWALLOW CENTER LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH JERSEY VOICE SPEECH AND SWALLOW CENTER LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1609100551
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/29/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1069 RINGWOOD AVE
Provider Second Line Business Mailing Address:
SUITE 311A
Provider Business Mailing Address City Name:
HASKELL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07420-1408
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-506-4447
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1069 RINGWOOD AVE
Provider Second Line Business Practice Location Address:
SUITE 311A
Provider Business Practice Location Address City Name:
HASKELL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07420-1408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-506-4447
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/24/2009

Additional Information

Authorized Official

Authorized Official Last Name:
FALCIGLIA
Authorized Official First Name:
DANIELLE
Authorized Official Middle Name:
NICOLETTA
Authorized Official Title or Position:
SPEECH PATHOLOGIST
Authorized Official Telephone Number:
973-506-4447

Provider Taxonomy Codes

  • Taxonomy code: 261QH0700X , with the licence number:  41YS00562500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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