MEDICARE: MIRANDA VAN DUNK

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	41YS00877000	NJ

General Provider Information

NPI Number	:	1770429227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRANDA VAN DUNK

Provider Business Mailing Address
First Line	:	9 HIGH POINT PL
Second Line	:
City	:	NORTH CALDWELL
State	:	NJ
Zip	:	07006-4517
Country	:	US
Telephone Number	:	973-809-2670
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 HIGH POINT PL
Second Line	:
City	:	NORTH CALDWELL
State	:	NJ
Zip	:	07006-4517
Country	:	US
Telephone Number	:	973-809-2670
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

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Directions to “ MIRANDA VAN DUNK ” Practice Location

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