MEDICARE: SPEECH & SWALLOW MATTERS 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
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1740110493
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPEECH & SWALLOW MATTERS LLC

Provider Business Mailing Address
First Line	:	11122 126TH ST
Second Line	:
City	:	SOUTH OZONE PARK
State	:	NY
Zip	:	11420-1511
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	190 LEWIS ST
Second Line	:
City	:	RAHWAY
State	:	NJ
Zip	:	07065-5078
Country	:	US
Telephone Number	:	914-908-3168
Fax Number	:

Authorized Official
Title or Position	:	SPEECH LANGAUGE PATHOLOGIST
Name	:	JESSICA BRUNY
Credential	:	PH.D., CCC-SLP
Telephone Number	:	914-980-3168

Provider Enumeration Date	:	05/22/2026
Last Update Date	:	05/22/2026

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Language	Start Address	Practice Location

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