MEDICARE: RIVKA HELLER

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

General Provider Information

NPI Number	:	1932619053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RIVKA HELLER

Provider Business Mailing Address
First Line	:	118 STRATFORD PL
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-1467
Country	:	US
Telephone Number	:	443-979-5324
Fax Number	:

Provider Business Practice Location Address
First Line	:	1375 RED OAK DR
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-3924
Country	:	US
Telephone Number	:	718-710-6356
Fax Number	:

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

Provider Enumeration Date	:	10/03/2017
Last Update Date	:	10/03/2017

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Directions to “ RIVKA HELLER ” Practice Location

Language	Start Address	Practice Location

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