Michelle Zaks, SPEECH PATHOLOGIST

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

TL-2140 Issued in NJ

Practice address

301 Sicomac Ave
Wyckoff, NJ 07481-2159

Phone

(201) 848-4300

Fax

(201) 848-4407

NPI assigned

Dec 11, 2012

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

Other names 1

• Michelle Weiss Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Saddle River, NJ
  • NPI 1689022295

  Speech-Language Pathologist

  NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1881939254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 INDIAN HOLLOW CT",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074303502",
            "telephone_number": "201-248-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SICOMAC AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074812159",
            "telephone_number": "201-848-4300",
            "fax_number": "201-848-4407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAKS",
        "first_name": "MICHELLE",
        "credential": "SPEECH PATHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-11",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "TL-2140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "WEISS",
            "credential": "SPEECH PATHOLOGIST",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wyckoff Optical, Inc.
• Wycoff-Nelson
• Mondana Sepahi Yazdi, M.D., F.A.A.P.
• Edward F Younghans, DPM
• Rafik Youssef, M.D.
• Henry Haifeng Zhou
• Amanda Klein Zoneraich, PSYD

• Speech-Language Pathologist in Wyckoff, NJ
• Providers in Wyckoff, 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 Jul 14, 2023; 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.