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NPI Code Detail

MEDICARE: REBECCA BAMBERGER SLP

MEDICARE: REBECCA BAMBERGER SLP
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
1235Z00000XSpeech-Language PathologistTL-3477NJ

General Provider Information

NPI Number : 1447859350
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA BAMBERGER SLP
Provider Business Mailing Address
First Line : 484 SOMERSET AVE
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-3602
Country : US
Telephone Number : 973-220-4718
Fax Number :
Provider Business Practice Location Address
First Line : 80 HILLSIDE BLVD
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-3798
Country : US
Telephone Number : 973-220-4718
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2020
Last Update Date : 10/21/2020

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Directions to “ REBECCA BAMBERGER SLP” Practice Location

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