Healthcare Provider Details

I. General information

NPI: 1134129067
Provider Name (Legal Business Name): SPEECH & HEARING ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 07/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 S EUCLID AVE
WESTFIELD NJ
07090-2129
US

IV. Provider business mailing address

121 S EUCLID AVE
WESTFIELD NJ
07090-2129
US

V. Phone/Fax

Practice location:
  • Phone: 908-232-2900
  • Fax: 908-232-3583
Mailing address:
  • Phone: 908-232-2900
  • Fax: 908-232-3583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41YS00099200
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number41YA00005300
License Number StateNJ

VIII. Authorized Official

Name: ROBERT W WOODS
Title or Position: DIRECTOR
Credential:
Phone: 908-232-2900