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NPI Code Detail

MEDICARE: ALYSSA FAYE BLUNK SLP

MEDICARE: ALYSSA FAYE BLUNK 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
1235Z00000XSpeech-Language PathologistSL016991PA

General Provider Information

NPI Number : 1912652041
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA FAYE BLUNK SLP
Provider Business Mailing Address
First Line : 440 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19130-4090
Country : US
Telephone Number : 215-400-4000
Fax Number :
Provider Business Practice Location Address
First Line : 440 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19130-4090
Country : US
Telephone Number : 215-400-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2022
Last Update Date : 05/07/2026

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Directions to “ ALYSSA FAYE BLUNK SLP” Practice Location

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