Provider Demographics
NPI:1699395129
Name:ORBACZEWSKI, ALYSSA
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:ORBACZEWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2058 BROADLANE RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08094-4074
Mailing Address - Country:US
Mailing Address - Phone:856-803-8206
Mailing Address - Fax:
Practice Address - Street 1:1035 N BLACK HORSE PIKE STE 6
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08094-2840
Practice Address - Country:US
Practice Address - Phone:856-885-2493
Practice Address - Fax:856-368-0780
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-24
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist