Provider Demographics
NPI:1487052502
Name:BEACON THERAPY SERVICES LLC
Entity type:Organization
Organization Name:BEACON THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:609-232-2661
Mailing Address - Street 1:8 BRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-3941
Mailing Address - Country:US
Mailing Address - Phone:609-232-2661
Mailing Address - Fax:732-534-2505
Practice Address - Street 1:8 BRIDGE CT
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-3941
Practice Address - Country:US
Practice Address - Phone:609-232-2661
Practice Address - Fax:732-534-2505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-06
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty