Provider Demographics
NPI:1871843714
Name:AURELIA, JOSEPH C JR (PHD CCCSLP)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:C
Last Name:AURELIA
Suffix:JR
Gender:M
Credentials:PHD CCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 GARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-3202
Mailing Address - Country:US
Mailing Address - Phone:781-662-5746
Mailing Address - Fax:
Practice Address - Street 1:255 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-3508
Practice Address - Country:US
Practice Address - Phone:617-660-2615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0048235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1194703520Medicaid
MA1194703520Medicare PIN