MEDICARE: DANYELA BERNDT-WILLIAMS

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	41YS00415000	NJ

General Provider Information

NPI Number	:	1235567421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANYELA BERNDT-WILLIAMS

Provider Business Mailing Address
First Line	:	218 BOULEVARD
Second Line	:
City	:	POMPTON PLAINS
State	:	NJ
Zip	:	07444-1903
Country	:	US
Telephone Number	:	973-641-6745
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 JACKSON AVE
Second Line	:
City	:	POMPTON PLAINS
State	:	NJ
Zip	:	07444-1447
Country	:	US
Telephone Number	:	973-641-6745
Fax Number	:

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

Provider Enumeration Date	:	10/24/2013
Last Update Date	:	10/24/2013

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Directions to “ DANYELA BERNDT-WILLIAMS ” Practice Location

Language	Start Address	Practice Location

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