Provider Demographics
NPI:1487145728
Name:SPEECH AND COMMUNICATION, LLC
Entity type:Organization
Organization Name:SPEECH AND COMMUNICATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP
Authorized Official - Prefix:
Authorized Official - First Name:BRACHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SKAIST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-237-6479
Mailing Address - Street 1:90 PONDEROSA DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5153
Mailing Address - Country:US
Mailing Address - Phone:732-276-6136
Mailing Address - Fax:
Practice Address - Street 1:90 PONDEROSA DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5153
Practice Address - Country:US
Practice Address - Phone:732-276-6136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00906300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty