Provider Demographics
NPI:1295179455
Name:IT'S MERYL TIME, LLC
Entity Type:Organization
Organization Name:IT'S MERYL TIME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENBLUM
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC
Authorized Official - Phone:856-489-5787
Mailing Address - Street 1:1930 ROUTE 70 E
Mailing Address - Street 2:SUITE E-30
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2150
Mailing Address - Country:US
Mailing Address - Phone:856-489-5787
Mailing Address - Fax:856-489-5799
Practice Address - Street 1:1930 ROUTE 70 E
Practice Address - Street 2:SUITE E-30
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2150
Practice Address - Country:US
Practice Address - Phone:856-489-5787
Practice Address - Fax:856-489-5799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00256200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty