Provider Demographics
NPI:1316380538
Name:LAKEWOOD SPEECH AND LANGUAGE CENTER
Entity Type:Organization
Organization Name:LAKEWOOD SPEECH AND LANGUAGE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC - SLP
Authorized Official - Phone:732-905-6475
Mailing Address - Street 1:425 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-2529
Mailing Address - Country:US
Mailing Address - Phone:732-905-6475
Mailing Address - Fax:732-905-6475
Practice Address - Street 1:425 3RD ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-2529
Practice Address - Country:US
Practice Address - Phone:732-905-6475
Practice Address - Fax:732-905-6475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00506700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty