Provider Demographics
NPI:1699027938
Name:LAZEWNIK, ROCHEL (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ROCHEL
Middle Name:
Last Name:LAZEWNIK
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 1:125 JENNA CT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5533
Mailing Address - Country:US
Mailing Address - Phone:732-886-8091
Mailing Address - Fax:
Practice Address - Street 1:125 JENNA CT
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5533
Practice Address - Country:US
Practice Address - Phone:732-886-8091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00525900235Z00000X
NY7168395235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist