MEDICARE: ELIZABETH BORNSTEIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	TL2181	NJ

General Provider Information

NPI Number	:	1053664284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH BORNSTEIN

Provider Business Mailing Address
First Line	:	263 WHITON ST APT 2
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07304-3559
Country	:	US
Telephone Number	:	908-625-2550
Fax Number	:	908-232-3583

Provider Business Practice Location Address
First Line	:	263 WHITON ST APT 2
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07304-3559
Country	:	US
Telephone Number	:	908-625-2550
Fax Number	:	908-232-3583

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2012
Last Update Date	:	05/20/2019

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Directions to “ ELIZABETH BORNSTEIN ” Practice Location

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