Provider Demographics
NPI:1073901633
Name:KLUGMAN, RIVKAH (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RIVKAH
Middle Name:
Last Name:KLUGMAN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 JAMES ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4101
Mailing Address - Country:US
Mailing Address - Phone:732-276-5593
Mailing Address - Fax:732-377-5484
Practice Address - Street 1:150 JAMES ST
Practice Address - Street 2:SUITE 202
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4101
Practice Address - Country:US
Practice Address - Phone:732-276-5593
Practice Address - Fax:732-377-5484
Is Sole Proprietor?:No
Enumeration Date:2015-01-06
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00619600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist