Eileen Anne Fasanella

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS00206300 Issued in NJ

Practice address

2 Woodmont Rd
Montclair, NJ 07043-2500

Phone

(973) 818-2164

NPI assigned

Mar 31, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1194303073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WOODMONT RD",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070432500",
            "telephone_number": "973-818-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WOODMONT RD",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070432500",
            "telephone_number": "973-818-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASANELLA",
        "first_name": "EILEEN",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00206300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Farkas, LCSW
• Umer Farooq, MD
• Robert Farrar, M.D.
• Ingrid Farrell, NP
• Tierney Farry, LPC, RYT
• FBH Health Services
• Robert Brett Fechner, LCSW
• Jennifer Federico, MA CCC-SLP
• Michael Feldman, PA-C
• Sara Wolf Feldman

• Speech-Language Pathologist in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.