Ellen Marie Anderson

Individual provider Active NPI Speech-Language Pathologist · Brick, NJ

NPI 1497313928 · NPPES record last updated May 30, 2019

Key facts

NPI
1497313928
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
41YS00980100 (NJ)
Practice address
2557 Hooper Ave
Brick, NJ 08723-6238
Phone
(732) 701-3711
Fax
(732) 701-3709
NPI assigned
May 30, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
41YS00980100NJMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Therapy Associates Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 41YS00980100 NJ Yes

Addresses

Primary practice location

2557 Hooper Ave
Brick, NJ 08723-6238

Mailing address

2557 Hooper Ave
Brick, NJ 08723-6238
Phone (732) 701-3711

Other providers in Brick, NJ

All providers in Brick, NJ · Speech-Language Pathologist in New Jersey

Sources for this page

Verify at the official NPI Registry.