Provider Demographics
NPI:1821095415
Name:PARAGON BILINGUAL THERAPY CENTER, LLC
Entity Type:Organization
Organization Name:PARAGON BILINGUAL THERAPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ADRIANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:201-662-2117
Mailing Address - Street 1:7225 BERGENLINE AVE
Mailing Address - Street 2:STE 2
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-5497
Mailing Address - Country:US
Mailing Address - Phone:201-662-2117
Mailing Address - Fax:201-662-2118
Practice Address - Street 1:7225 BERGENLINE AVE
Practice Address - Street 2:STE 2
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-5497
Practice Address - Country:US
Practice Address - Phone:201-662-2117
Practice Address - Fax:201-662-2118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00422900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
11470713OtherCAQH PROVIDER ID