MEDICARE: STEPHANIE SADUSKY M.A., CCC-SLP

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	04-000572	DE

General Provider Information

NPI Number	:	1841786175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE SADUSKY M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	130 COUPLES DR
Second Line	:
City	:	NEWARK
State	:	DE
Zip	:	19702-2389
Country	:	US
Telephone Number	:	302-632-9230
Fax Number	:

Provider Business Practice Location Address
First Line	:	1221 CEDAR LANE RD
Second Line	:
City	:	MIDDLETOWN
State	:	DE
Zip	:	19709-9636
Country	:	US
Telephone Number	:	302-449-5873
Fax Number	:

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

Provider Enumeration Date	:	07/10/2018
Last Update Date	:	04/03/2020

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