Provider Demographics
NPI:1396878740
Name:CENTER FOR SPEECH AND HEARING SCIENCES
Entity type:Organization
Organization Name:CENTER FOR SPEECH AND HEARING SCIENCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR AUDIOLOGY
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:MSCCC-A
Authorized Official - Phone:732-238-1664
Mailing Address - Street 1:44 MILLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-2356
Mailing Address - Country:US
Mailing Address - Phone:732-238-1664
Mailing Address - Fax:732-613-9795
Practice Address - Street 1:44 MILLTOWN RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-2356
Practice Address - Country:US
Practice Address - Phone:732-238-1664
Practice Address - Fax:732-613-9795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ235Z00000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ205833T6QMedicare UPIN