Speech Therapy Source Inc is a medicare enrolled "Clinic/center - Rehabilitation" provider in Clifton, New Jersey. Their current practice location is
227 Lakeview Ave, Clifton, New Jersey. You can reach out to their office (for appointments etc.) via phone at
(201) 543-8524.
Speech Therapy Source Inc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Speech Therapy Source Inc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1356177356.
Healthcare Provider's Profile
| Full Name | Speech Therapy Source Inc |
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| Type | Facility |
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| Speciality | Clinic/center - Rehabilitation |
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| Location | 227 Lakeview Ave, Clifton, New Jersey |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1356177356
- Provider Enumeration Date: 09/09/2024
- Last Update Date: 09/26/2024
Medicare PECOS Information:
- PECOS PAC ID: 0648702068
- Enrollment ID: O20241010000567
Medical Identifiers
Medical identifiers for Speech Therapy Source Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1356177356 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Secondary |
| 261QR0400X | Clinic/center - Rehabilitation | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Speech Therapy Source Inc acts as a billing entity for following providers:
| Provider Name | Mohammad N Alqudah |
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| Provider Type | Practitioner - Qualified Speech Language Pathologist |
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| Provider Identifiers | NPI Number: 1831512011
PECOS PAC ID: 6507096823
Enrollment ID: I20140307000030 |
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| Provider Name | Sonia Boksh |
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| Provider Type | Practitioner - Qualified Speech Language Pathologist |
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| Provider Identifiers | NPI Number: 1912605957
PECOS PAC ID: 7719418227
Enrollment ID: I20241008000403 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Speech Therapy Source Inc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Speech Therapy Source Inc
227 Lakeview Ave,
Clifton, NJ 07011-4011
Ph: (201) 543-8524 | Speech Therapy Source Inc
227 Lakeview Ave,
Clifton, NJ 07011-4011
Ph: (201) 543-8524 |
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