Provider Demographics
NPI:1164185922
Name:OPPENHEIM, MADELEINE OLIVIA (CF-SLP)
Entity Type:Individual
Prefix:
First Name:MADELEINE
Middle Name:OLIVIA
Last Name:OPPENHEIM
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 TUNBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2242
Mailing Address - Country:US
Mailing Address - Phone:609-217-5681
Mailing Address - Fax:
Practice Address - Street 1:536 RIDGE RD
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-1611
Practice Address - Country:US
Practice Address - Phone:973-239-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist