MEDICARE: VIRAL LANDSMAN M.S. 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	SLP8206	MA

General Provider Information

NPI Number	:	1992538268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRAL LANDSMAN M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	PO BOX 360
Second Line	:
City	:	MOORESTOWN
State	:	NJ
Zip	:	08057-0360
Country	:	US
Telephone Number	:	215-499-5448
Fax Number	:

Provider Business Practice Location Address
First Line	:	253 WASHINGTON ST
Second Line	:
City	:	HUDSON
State	:	MA
Zip	:	01749-2979
Country	:	US
Telephone Number	:	215-499-5448
Fax Number	:

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

Provider Enumeration Date	:	08/22/2024
Last Update Date	:	08/22/2024

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Directions to “ VIRAL LANDSMAN M.S. CCC-SLP” Practice Location

Language	Start Address	Practice Location

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