Provider Demographics
NPI:1871838664
Name:KRESSNER, CHAYA (SLP)
Entity type:Individual
Prefix:
First Name:CHAYA
Middle Name:
Last Name:KRESSNER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 TREESIDE LN
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5449
Mailing Address - Country:US
Mailing Address - Phone:732-363-6331
Mailing Address - Fax:
Practice Address - Street 1:18 TREESIDE LN
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5449
Practice Address - Country:US
Practice Address - Phone:732-363-6331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017203235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist