MEDICARE: JONATHAN RAND

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	006991	NY

General Provider Information

NPI Number	:	1386926541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN RAND

Provider Business Mailing Address
First Line	:	143 SPRINGHILL DR
Second Line	:
City	:	MORRIS PLAINS
State	:	NJ
Zip	:	07950-1175
Country	:	US
Telephone Number	:	973-292-1124
Fax Number	:

Provider Business Practice Location Address
First Line	:	143 SPRINGHILL DR
Second Line	:
City	:	MORRIS PLAINS
State	:	NJ
Zip	:	07950-1175
Country	:	US
Telephone Number	:	973-292-1124
Fax Number	:

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

Provider Enumeration Date	:	09/14/2011
Last Update Date	:	09/14/2011

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Directions to “ JONATHAN RAND ” Practice Location

Language	Start Address	Practice Location

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