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NPI Code Detail

MEDICARE: BARBARA AMY BRUDNICKI MA, CCC-SLP

MEDICARE: BARBARA AMY BRUDNICKI MA, CCC-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 PathologistSL015030PA

General Provider Information

NPI Number : 1508439738
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA AMY BRUDNICKI MA, CCC-SLP
Provider Business Mailing Address
First Line : 6334 HEGERMAN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19135-3302
Country : US
Telephone Number : 215-876-7346
Fax Number :
Provider Business Practice Location Address
First Line : 600 W CHELTENHAM AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19126-3045
Country : US
Telephone Number : 215-927-7300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2021
Last Update Date : 07/25/2021

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