Provider Demographics
NPI:1114760261
Name:KLECZKOWSKI, SEAN THOMAS (DOCTOR OF AUDIOLOGY)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:THOMAS
Last Name:KLECZKOWSKI
Suffix:
Gender:M
Credentials:DOCTOR OF AUDIOLOGY
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Other - Credentials:
Mailing Address - Street 1:74 MONTAGUE PL APT 4
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2847
Mailing Address - Country:US
Mailing Address - Phone:860-416-8887
Mailing Address - Fax:
Practice Address - Street 1:23 W PALISADE AVE
Practice Address - Street 2:23 W PALISADE AVE
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2705
Practice Address - Country:US
Practice Address - Phone:201-408-4441
Practice Address - Fax:201-408-4452
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist