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NPI Code Detail

MEDICARE: PAMELA SPECK

MEDICARE:   PAMELA  SPECK
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
1225100000XPhysical TherapistQA02603NJ

General Provider Information

NPI Number : 1588782379
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA SPECK
Provider Business Mailing Address
First Line : 4 PHYLLIS DR
Second Line :
City : MONTVALE
State : NJ
Zip : 07645-1438
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 330 FRANKLIN TPKE
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-1932
Country : US
Telephone Number : 201-447-1900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2007
Last Update Date : 07/08/2007

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Directions to “ PAMELA SPECK ” Practice Location

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