Healthcare Provider Details

I. General information

NPI: 1568776706
Provider Name (Legal Business Name): ALANA OBUHOVS M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 09/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PINE ST
LAKEWOOD NJ
08701-4963
US

IV. Provider business mailing address

7 MONTANA DR
JACKSON NJ
08527-2116
US

V. Phone/Fax

Practice location:
  • Phone: 732-534-7325
  • Fax:
Mailing address:
  • Phone: 732-367-7249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number016318
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: