MEDICARE: THE SPECIAL CHILDREN CENTER

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	:	1871985994
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE SPECIAL CHILDREN CENTER

Provider Business Mailing Address
First Line	:	1400 PROSPECT ST.
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701
Country	:	US
Telephone Number	:	732-367-0099
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 PROSPECT ST
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-4611
Country	:	US
Telephone Number	:	732-367-0099
Fax Number	:	732-367-1518

Authorized Official
Title or Position	:	DIRECTOR OF FINANCE
Name	:	MR. AARON NUSSBACHER
Credential	:
Telephone Number	:	732-367-0099

Provider Enumeration Date	:	02/26/2015
Last Update Date	:	09/27/2017

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Directions to “THE SPECIAL CHILDREN CENTER ” Practice Location

Language	Start Address	Practice Location

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