| Pocono Speech Center, Llc | |
|
1219 N 5th St, Stroudsburg, PA 18360-2646 | |
| (570) 421-2232 | |
| (570) 421-1825 |
| Full Name | Pocono Speech Center, Llc |
|---|---|
| Type | Facility |
| Speciality | Speech-language Pathologist |
| Location | 1219 N 5th St, Stroudsburg, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477635621 | NPI | - | NPPES |
| 0018260230003 | Medicaid | PA | |
| PO540401 | Other | PA | BCBS GROUP ID # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | SL004836L (Pennsylvania) | Primary |
| Provider Name | Sandra S Defino |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1255321964 PECOS PAC ID: 3072653005 Enrollment ID: I20091222000537 |
| Mailing Address | Practice Location Address |
|---|---|
| Pocono Speech Center, Llc 1219 N 5th St, Stroudsburg, PA 18360-2646 Ph: (570) 421-2232 | Pocono Speech Center, Llc 1219 N 5th St, Stroudsburg, PA 18360-2646 Ph: (570) 421-2232 |
Cierra Monet Marks, MS CF-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1329 Kelly Rd, Stroudsburg, PA 18360 Phone: 917-513-0038 | |
Mrs. Jodi Renee Kresge, M.S., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1219 N 5th St, Stroudsburg, PA 18360 Phone: 570-421-2232 Fax: 570-421-1825 | |
Aubry Kacsur, MS CCC-SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 4227 Manor Dr, Stroudsburg, PA 18360 Phone: 724-327-3553 | |
Mrs. Denise Marie Gerenza, MS,CCC/SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 808 Pin Oak Rd, Stroudsburg, PA 18360 Phone: 570-688-0631 | |
Shannon Smith, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 4227 Manor Dr, Stroudsburg, PA 18360 Phone: 570-992-4172 | |
Mrs. Tracy Lyn Bajadek, MS, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1219 N 5th St, Stroudsburg, PA 18360 Phone: 570-421-2232 Fax: 570-421-1825 | |
Jenna E Hess, MS CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 100 St Lukes Ln, Stroudsburg, PA 18360 Phone: 272-212-1000 |