Provider Demographics
NPI:1003564972
Name:THERAPEDSNJ LLC
Entity Type:Organization
Organization Name:THERAPEDSNJ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTR/L
Authorized Official - Prefix:MRS
Authorized Official - First Name:RIVKA
Authorized Official - Middle Name:
Authorized Official - Last Name:FREUNDLICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-642-4266
Mailing Address - Street 1:15 LINDA DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-5025
Mailing Address - Country:US
Mailing Address - Phone:845-642-4266
Mailing Address - Fax:
Practice Address - Street 1:15 LINDA DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-5025
Practice Address - Country:US
Practice Address - Phone:845-642-4266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty