Provider Demographics
NPI:1003189176
Name:SEEWALD, SULAMIF (MS/CCC/SLP)
Entity Type:Individual
Prefix:
First Name:SULAMIF
Middle Name:
Last Name:SEEWALD
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 1:27 WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:PINE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07058-9621
Mailing Address - Country:US
Mailing Address - Phone:973-287-7224
Mailing Address - Fax:973-287-7224
Practice Address - Street 1:28 BLOOMFIELD AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:PINE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07058-9903
Practice Address - Country:US
Practice Address - Phone:973-244-2448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-20
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00582500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist