Provider Demographics
NPI:1962178996
Name:BAMBERGER, JUDITH (SLP)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:BAMBERGER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 OLD NYACK TPKE UNIT 212
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-4019
Mailing Address - Country:US
Mailing Address - Phone:973-666-0527
Mailing Address - Fax:
Practice Address - Street 1:25 ROBERT PITT DR STE 106
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-3366
Practice Address - Country:US
Practice Address - Phone:845-426-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist