Provider Demographics
NPI:1760832190
Name:VAKULCHIK, MONIKA STARR (MED, MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MONIKA
Middle Name:STARR
Last Name:VAKULCHIK
Suffix:
Gender:F
Credentials:MED, 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 1:1120 EVA ST
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-3341
Mailing Address - Country:US
Mailing Address - Phone:732-424-8746
Mailing Address - Fax:
Practice Address - Street 1:1120 EVA ST
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-3341
Practice Address - Country:US
Practice Address - Phone:732-424-8746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00737900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist