Healthcare Provider Details

I. General information

NPI: 1669695763
Provider Name (Legal Business Name): RACHEL FISCH-KAPLAN, MS CCC-SLP, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 11/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 UNION PL SUITE 315
SUMMIT NJ
07901-2568
US

IV. Provider business mailing address

57 UNION PL SUITE 315
SUMMIT NJ
07901-2568
US

V. Phone/Fax

Practice location:
  • Phone: 908-273-5537
  • Fax: 908-277-1677
Mailing address:
  • Phone: 908-273-5537
  • Fax: 908-277-1677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41YS00281300
License Number StateNJ

VIII. Authorized Official

Name: MR. RUSSELL KAPLAN
Title or Position: ADMINISTRATIVE DIRECTOR & TREASURER
Credential:
Phone: 908-273-5537