Peter Anthony Koberle, | |
42 N Mountain Ave, Montclair, NJ 07042-2318 | |
(973) 783-9400 | |
(973) 783-8499 |
Full Name | Peter Anthony Koberle |
---|---|
Gender | Male |
Speciality | Speech-language Pathologist |
Location | 42 N Mountain Ave, Montclair, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1417172339 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | 41YS00296100 (New Jersey) | Primary |
Provider Name | Aegis Group Practice Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1972288728 PECOS PAC ID: 5193036432 Enrollment ID: O20231018000657 |
Mailing Address | Practice Location Address |
---|---|
Peter Anthony Koberle, 188 Claremont Ave, Apt. #47, Montclair, NJ 07042-3525 Ph: () - | Peter Anthony Koberle, 42 N Mountain Ave, Montclair, NJ 07042-2318 Ph: (973) 783-9400 |
Speech Genie Therapeutic Services Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 18-20 Lackawanna Plz Ste 300, Montclair, NJ 07042 Phone: 973-826-0595 | |
Jaclyn Nicole Bougades, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 17 Watchung Plz, Montclair, NJ 07042 Phone: 973-744-0804 | |
Ayana Webb, M.A., CCC-SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 33 Hillside Ave Apt 7, Montclair, NJ 07042 Phone: 732-675-0279 | |
Mary Gagliardotto, MA, CF-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 17 Watchung Plz, Montclair, NJ 07042 Phone: 973-744-0804 | |
Jill Lynne Hollander, MA, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 7 Bell St Apt 104, Montclair, NJ 07042 Phone: 197-376-8899 | |
Cara Cilento, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 51 Upper Montclair Plz, Montclair, NJ 07043 Phone: 973-519-1989 | |
Brielle Korin Stern, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 17 Watchung Plz, Montclair, NJ 07042 Phone: 973-744-0804 |