Provider Demographics
NPI:1578841383
Name:KAGAN, JUDITH ARIELLA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:ARIELLA
Last Name:KAGAN
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 1:39 PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-2450
Mailing Address - Country:US
Mailing Address - Phone:973-471-5536
Mailing Address - Fax:
Practice Address - Street 1:39 PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-2450
Practice Address - Country:US
Practice Address - Phone:973-471-5536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00624600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist