MEDICARE: SPEECH LANGUAGE INSTITUTE

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

General Provider Information

NPI Number	:	1538784756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPEECH LANGUAGE INSTITUTE

Provider Business Mailing Address
First Line	:	38 WILLOW WAY
Second Line	:
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-1855
Country	:	US
Telephone Number	:	973-449-6277
Fax Number	:

Provider Business Practice Location Address
First Line	:	38 WILLOW WAY
Second Line	:
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-1855
Country	:	US
Telephone Number	:	973-449-6277
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. SHIVANI RAINA
Credential	:	SLP.D
Telephone Number	:	973-449-6277

Provider Enumeration Date	:	06/12/2020
Last Update Date	:	06/12/2020

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Directions to “SPEECH LANGUAGE INSTITUTE ” Practice Location

Language	Start Address	Practice Location

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