Provider Demographics
NPI:1437446978
Name:WALDRON, ROBERT ERIC (MS, CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ERIC
Last Name:WALDRON
Suffix:
Gender:M
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 JEFFERSON PL
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-2338
Mailing Address - Country:US
Mailing Address - Phone:201-264-4657
Mailing Address - Fax:201-307-8847
Practice Address - Street 1:29 JEFFERSON PL
Practice Address - Street 2:
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-2338
Practice Address - Country:US
Practice Address - Phone:201-264-4657
Practice Address - Fax:201-307-8847
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00641700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist