Provider Demographics
NPI:1851108393
Name:ROSENMAN, LEAH BRACHA (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:BRACHA
Last Name:ROSENMAN
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 1:1518 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1564
Mailing Address - Country:US
Mailing Address - Phone:574-334-0769
Mailing Address - Fax:
Practice Address - Street 1:140 REGENT DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3026
Practice Address - Country:US
Practice Address - Phone:732-856-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01187000235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist