Provider Demographics
NPI:1902304868
Name:PAPANDREA, MEGAN THERESA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:THERESA
Last Name:PAPANDREA
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-1828
Mailing Address - Country:US
Mailing Address - Phone:908-377-7327
Mailing Address - Fax:
Practice Address - Street 1:10 ALDEN ST
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2176
Practice Address - Country:US
Practice Address - Phone:908-377-7327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00880800235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist