=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396111431
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ESTHER FREUNDLICH SPEECH THERAPY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2015
-----------------------------------------------------
Last Update Date | 08/12/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2 TRUMAN AVE
-----------------------------------------------------
City | LAKEWOOD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08701-5662
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-608-6572
-----------------------------------------------------
Fax | 732-370-1973
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2 TRUMAN AVE
-----------------------------------------------------
City | LAKEWOOD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08701-5662
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-608-6572
-----------------------------------------------------
Fax | 732-370-1973
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPEECH LANGUAGE PATHOLOGIST
-----------------------------------------------------
Name | ESTHER FREUNDLICH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 845-608-6572
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QH0700X
-----------------------------------------------------
Taxonomy Name | Hearing and Speech Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------