Provider Demographics
NPI:1982345260
Name:BERGEN COUNTY SPEECH SERVICES
Entity Type:Organization
Organization Name:BERGEN COUNTY SPEECH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SINGLE-MEMBER LLC
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGANELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:201-615-3781
Mailing Address - Street 1:1 KALISA WAY STE 311
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3508
Mailing Address - Country:US
Mailing Address - Phone:201-615-3781
Mailing Address - Fax:
Practice Address - Street 1:1 KALISA WAY STE 311
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3508
Practice Address - Country:US
Practice Address - Phone:201-615-3781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-02
Last Update Date:2022-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech