Provider Demographics
NPI:1518783117
Name:CASQUEIRA, ELIANA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ELIANA
Middle Name:
Last Name:CASQUEIRA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 49
Mailing Address - Street 2:
Mailing Address - City:BRANCHVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07826-0049
Mailing Address - Country:US
Mailing Address - Phone:973-670-8210
Mailing Address - Fax:
Practice Address - Street 1:16 WANTAGE AVE
Practice Address - Street 2:
Practice Address - City:BRANCHVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07826-5640
Practice Address - Country:US
Practice Address - Phone:973-670-8210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ54698235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist