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NPI Code Detail

MEDICARE: MRS. YEHUDIS BORTZ SLP

MEDICARE:  MRS. YEHUDIS  BORTZ  SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist41YS01189700NJ

General Provider Information

NPI Number : 1417728486
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. YEHUDIS BORTZ SLP
Provider Business Mailing Address
First Line : 5 MELROSE CT
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-3952
Country : US
Telephone Number : 410-562-6377
Fax Number :
Provider Business Practice Location Address
First Line : 1500 AVENUE OF THE STATES
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-4789
Country : US
Telephone Number : 732-813-1858
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2024
Last Update Date : 01/09/2024

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Directions to “ MRS. YEHUDIS BORTZ SLP” Practice Location

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