Provider Demographics
NPI:1205409885
Name:PUSKUS, BRENDA
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:PUSKUS
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 1:950 ROUTE 36
Mailing Address - Street 2:
Mailing Address - City:LEONARDO
Mailing Address - State:NJ
Mailing Address - Zip Code:07737-1709
Mailing Address - Country:US
Mailing Address - Phone:908-461-2831
Mailing Address - Fax:732-335-6759
Practice Address - Street 1:950 ROUTE 36
Practice Address - Street 2:
Practice Address - City:LEONARDO
Practice Address - State:NJ
Practice Address - Zip Code:07737-1709
Practice Address - Country:US
Practice Address - Phone:908-461-2831
Practice Address - Fax:732-335-6759
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant