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NPI 1093590622ActiveIndividual· Speech-Language Pathologist· Warren, NJ
Speech-Language Pathologist with Synaptic Rehabilitation LLC, practicing in Warren, New Jersey. Enrolled in Medicare as practitioner - qualified speech language pathologist.
Overview
| NPI | 1093590622 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Aug 30, 2023 |
| Last updated in NPPES | Aug 30, 2023 |
| Certified by provider | Aug 30, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | 41YS01213000 | NJ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Qualified Speech Language Pathologist (NJ) |
|---|
Education and affiliations
| Graduation year | 2022 |
|---|---|
| Medicare specialty | Qualified Speech Language Pathologist |
Medical group
- Synaptic Rehabilitation LLCWarren, NJ · 20 clinicians
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All 18 speech-language pathologists in Warren · All speech-language pathologists in New Jersey