Provider Demographics
NPI:1447595152
Name:BEZPALKO, FIANA (MS-CCC-SLP)
Entity Type:Individual
Prefix:
First Name:FIANA
Middle Name:
Last Name:BEZPALKO
Suffix:
Gender:F
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 1:900 PALISADE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-4135
Mailing Address - Country:US
Mailing Address - Phone:201-218-4389
Mailing Address - Fax:
Practice Address - Street 1:900 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-4135
Practice Address - Country:US
Practice Address - Phone:201-218-4389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00677500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist