Healthcare Provider Details

I. General information

NPI: 1538995915
Provider Name (Legal Business Name): TAMAR ESKENAZI CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2024
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 KINDERKAMACK RD STE 308
WESTWOOD NJ
07675-3021
US

IV. Provider business mailing address

319 E MIDLAND AVE
PARAMUS NJ
07652-5751
US

V. Phone/Fax

Practice location:
  • Phone: 908-787-8387
  • Fax:
Mailing address:
  • Phone: 201-696-0032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41YS01270700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: