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NPI Code Detail

MEDICARE: JILL DANIELS PARADISE

MEDICARE:   JILL DANIELS PARADISE
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 Pathologist41YS00434400NJ

General Provider Information

NPI Number : 1528251634
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL DANIELS PARADISE
Provider Business Mailing Address
First Line : 708 OLD FARM RD
Second Line :
City : POINT PLEASANT BORO
State : NJ
Zip : 08742-4046
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 708 OLD FARM RD
Second Line :
City : POINT PLEASANT BORO
State : NJ
Zip : 08742-4046
Country : US
Telephone Number : 973-580-0057
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2007
Last Update Date : 02/18/2016

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Directions to “ JILL DANIELS PARADISE ” Practice Location

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