Provider Demographics
NPI:1053650168
Name:BRAUN, HADASSAH
Entity Type:Individual
Prefix:
First Name:HADASSAH
Middle Name:
Last Name:BRAUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 WINDERMERE ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5259
Mailing Address - Country:US
Mailing Address - Phone:732-961-2294
Mailing Address - Fax:
Practice Address - Street 1:500 RIVER AVE
Practice Address - Street 2:SUITE 245
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4738
Practice Address - Country:US
Practice Address - Phone:732-367-1888
Practice Address - Fax:732-367-5910
Is Sole Proprietor?:No
Enumeration Date:2013-02-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00657500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist