Provider Demographics
NPI:1083437602
Name:ACKERMAN, MEGAN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:ACKERMAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 CATHY PL
Mailing Address - Street 2:
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1003
Mailing Address - Country:US
Mailing Address - Phone:973-897-3787
Mailing Address - Fax:
Practice Address - Street 1:135 COLUMBIA TPKE
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-2104
Practice Address - Country:US
Practice Address - Phone:973-283-5664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ14414595235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist