MEDICARE: NAOMI SUTTON 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
1	235Z00000X	Speech-Language Pathologist	41YS00635500	NJ

General Provider Information

NPI Number	:	1629344494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAOMI SUTTON SLP

Provider Business Mailing Address
First Line	:	17 RUMSON RD
Second Line	:
City	:	LIVINGSTON
State	:	NJ
Zip	:	07039-3312
Country	:	US
Telephone Number	:	516-476-1260
Fax Number	:

Provider Business Practice Location Address
First Line	:	1211 HAMBURG TPKE STE 224
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-5056
Country	:	US
Telephone Number	:	973-800-8515
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2012
Last Update Date	:	04/17/2019

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Directions to “ NAOMI SUTTON SLP” Practice Location

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