Healthcare Provider Details

I. General information

NPI: 1972806180
Provider Name (Legal Business Name): HANNAH BIRNBAUM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHANI BIRNBAUM MA CCC SLP

II. Dates (important events)

Enumeration Date: 12/09/2010
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 KANSAS DR
JACKSON NJ
08527-1515
US

IV. Provider business mailing address

1 KANSAS DR
JACKSON NJ
08527-1515
US

V. Phone/Fax

Practice location:
  • Phone: 848-525-7564
  • Fax:
Mailing address:
  • Phone: 732-237-5473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: