Individual
PEGAH ANSARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
214 FIRST AVENUE, NEWARK, NJ 07107
(973) 268-5240
Mailing address
66 CHERRY ST, CLIFTON, NJ 07014-1316
(551) 358-5173
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41VS01343800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41VS01343800
STATELICENSENUMBER
NJ
Enumeration date
12/18/2025
Last updated
12/18/2025
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