Provider Demographics
NPI:1861821373
Name:TEANECK SPEECH AND LANGUAGE CENTER
Entity Type:Organization
Organization Name:TEANECK SPEECH AND LANGUAGE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER, TSLC
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KORNBLUTH
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC
Authorized Official - Phone:201-862-0333
Mailing Address - Street 1:107 W TRYON AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-3605
Mailing Address - Country:US
Mailing Address - Phone:201-862-0333
Mailing Address - Fax:201-862-1130
Practice Address - Street 1:107 W TRYON AVE
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-3605
Practice Address - Country:US
Practice Address - Phone:201-862-0333
Practice Address - Fax:201-862-1130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty