Provider Demographics
NPI:1659077691
Name:AMOINZADEHSLP
Entity Type:Organization
Organization Name:AMOINZADEHSLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH AND LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:AYELET
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVYCHAIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-991-9983
Mailing Address - Street 1:41 MAPLEWOOD TER
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-2991
Mailing Address - Country:US
Mailing Address - Phone:443-991-9983
Mailing Address - Fax:
Practice Address - Street 1:41 MAPLEWOOD TER
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-2991
Practice Address - Country:US
Practice Address - Phone:443-991-9983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty