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NPI Code Detail

MEDICARE: SPEECH AND READING ACADEMY, LLC

MEDICARE: SPEECH AND READING ACADEMY, 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 Pathologist41YS00651500NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11447543756OTHERHORIZON BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1720579915
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPEECH AND READING ACADEMY, LLC
Provider Business Mailing Address
First Line : 8 OLD BRIDGE TPKE
Second Line :
City : SOUTH RIVER
State : NJ
Zip : 08882-2400
Country : US
Telephone Number : 732-698-8766
Fax Number :
Provider Business Practice Location Address
First Line : 8 OLD BRIDGE TPKE
Second Line :
City : SOUTH RIVER
State : NJ
Zip : 08882-2400
Country : US
Telephone Number : 732-698-8766
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SANDRA SHARBASH
Credential : M.A. CCC-SLP
Telephone Number : 732-698-8766
Provider Enumeration Date : 05/23/2018
Last Update Date : 05/23/2018

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Directions to “SPEECH AND READING ACADEMY, LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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