Provider Demographics
NPI:1427868256
Name:SUSSEX CONSORTIUM
Entity type:Organization
Organization Name:SUSSEX CONSORTIUM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:AIDA
Authorized Official - Last Name:BLAU
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:908-907-1940
Mailing Address - Street 1:17344 SWEETBRIAR RD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-4021
Mailing Address - Country:US
Mailing Address - Phone:302-645-7210
Mailing Address - Fax:
Practice Address - Street 1:17344 SWEETBRIAR RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-4021
Practice Address - Country:US
Practice Address - Phone:302-645-7210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech