Provider Demographics
NPI:1306660741
Name:ELFALLAH, SARAH MARGARET (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MARGARET
Last Name:ELFALLAH
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 1:505 BRITTANY DR
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-3254
Mailing Address - Country:US
Mailing Address - Phone:813-817-2229
Mailing Address - Fax:
Practice Address - Street 1:1 PIKE DR
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2443
Practice Address - Country:US
Practice Address - Phone:315-889-1690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01287500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist