Provider Demographics
NPI:1558988857
Name:KULIK, CHAVA
Entity Type:Individual
Prefix:
First Name:CHAVA
Middle Name:
Last Name:KULIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHAVA
Other - Middle Name:
Other - Last Name:NIMCHINSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:99 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4208
Mailing Address - Country:US
Mailing Address - Phone:646-715-5448
Mailing Address - Fax:
Practice Address - Street 1:2 STACY CT
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-2912
Practice Address - Country:US
Practice Address - Phone:516-815-0183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist