Individual
MR. MACIEJ MODZELEWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S. CCC-SLP
Contact information
Practice address
415 N 5TH ST, HARRISON, NJ 07029-1201
(973) 482-6960
Mailing address
415 N 5TH ST, HARRISON, NJ 07029-1201
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00696800
NJ
Other
Enumeration date
11/26/2013
Last updated
11/26/2013
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