Provider Demographics
NPI:1437535374
Name:CIELESZ, AMANDA BRITTANY (AUD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:BRITTANY
Last Name:CIELESZ
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 BROAD ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3000
Mailing Address - Country:US
Mailing Address - Phone:973-338-0309
Mailing Address - Fax:
Practice Address - Street 1:1255 BROAD ST
Practice Address - Street 2:SUITE 206
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-3000
Practice Address - Country:US
Practice Address - Phone:973-338-0309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00090900231H00000X
NJ25MG00136500237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter