Provider Demographics
NPI:1205256476
Name:GLANZBERG SPEECH AND VOICE IMPROVEMENT CENTER, LLC
Entity type:Organization
Organization Name:GLANZBERG SPEECH AND VOICE IMPROVEMENT CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GLANZBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:908-553-7854
Mailing Address - Street 1:114 DONATO CIR
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-1068
Mailing Address - Country:US
Mailing Address - Phone:908-553-7854
Mailing Address - Fax:908-450-1449
Practice Address - Street 1:114 DONATO CIR
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-1068
Practice Address - Country:US
Practice Address - Phone:908-553-7854
Practice Address - Fax:908-450-1449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-25
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00402100302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization