Provider Demographics
NPI:1790552370
Name:SOLOVEITCHIK, YEHUDIS
Entity Type:Individual
Prefix:
First Name:YEHUDIS
Middle Name:
Last Name:SOLOVEITCHIK
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 1:18 NEWBERRY CT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5402
Mailing Address - Country:US
Mailing Address - Phone:845-608-6459
Mailing Address - Fax:
Practice Address - Street 1:415 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4868
Practice Address - Country:US
Practice Address - Phone:908-415-3857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTR-4031235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist