Provider Demographics
NPI:1174930135
Name:FEED-FIRST PEDIATRIC FEEDING & SPEECH PATHOLOGY SERVICES, LLC
Entity type:Organization
Organization Name:FEED-FIRST PEDIATRIC FEEDING & SPEECH PATHOLOGY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:AMBIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATTACHARYA
Authorized Official - Suffix:
Authorized Official - Credentials:MACCC-SLP
Authorized Official - Phone:732-910-4445
Mailing Address - Street 1:714 CHELSEA RD
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-1884
Mailing Address - Country:US
Mailing Address - Phone:732-910-4445
Mailing Address - Fax:
Practice Address - Street 1:714 CHELSEA RD
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-1884
Practice Address - Country:US
Practice Address - Phone:732-910-4445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-22
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00653000235Z00000X
NJ41YS00552900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty