Provider Demographics
NPI:1972292944
Name:CONFORTI, AUDREY ELLA
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:ELLA
Last Name:CONFORTI
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 1:2561 SUMMIT RD
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-2319
Mailing Address - Country:US
Mailing Address - Phone:732-539-9849
Mailing Address - Fax:
Practice Address - Street 1:47 RARITAN AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-2440
Practice Address - Country:US
Practice Address - Phone:732-763-5593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist