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NPI Code Detail

MEDICARE: MEDLEY & MESARIC THERAPY ASSICIATES, LLC

MEDICARE: MEDLEY & MESARIC THERAPY ASSICIATES, LLC
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 PathologistSL008160PA

General Provider Information

NPI Number : 1700193802
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDLEY & MESARIC THERAPY ASSICIATES, LLC
Provider Business Mailing Address
First Line : 449 PENNSYLVANIA AVE
Second Line :
City : FORT WASHINGTON
State : PA
Zip : 19034-3414
Country : US
Telephone Number : 215-643-5585
Fax Number :
Provider Business Practice Location Address
First Line : 449 PENNSYLVANIA AVE
Second Line :
City : FORT WASHINGTON
State : PA
Zip : 19034-3414
Country : US
Telephone Number : 215-643-5585
Fax Number :
Authorized Official
Title or Position : CO-DIRECTOR
Name : MS. JANICE L MESARIC
Credential : M.S., CCC-SLP
Telephone Number : 215-643-5585
Provider Enumeration Date : 09/10/2010
Last Update Date : 09/10/2010

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Directions to “MEDLEY & MESARIC THERAPY ASSICIATES, LLC ” Practice Location

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