Provider Demographics
NPI:1194152678
Name:NEW JERSEY PEDIATRIC FEEDING ASSOCIATES
Entity type:Organization
Organization Name:NEW JERSEY PEDIATRIC FEEDING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:CALAMUSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-698-1100
Mailing Address - Street 1:150C TICES LN
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-2015
Mailing Address - Country:US
Mailing Address - Phone:732-698-1100
Mailing Address - Fax:732-698-1140
Practice Address - Street 1:150C TICES LN
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-2015
Practice Address - Country:US
Practice Address - Phone:732-698-1100
Practice Address - Fax:732-698-1140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1197363235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty