Jacqueline M Aguilar
Individual provider Active NPI Speech-Language Pathologist · Medford, NY
NPI 1154575231 · NPPES record last updated Nov 16, 2008
Key facts
- NPI
- 1154575231
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 012339-1 (NY)
- Practice address
- 304 Peconic Ave
Medford, NY 11763-3549 - Phone
- (631) 730-5318
- NPI assigned
- Nov 16, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012339-1 | NY | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 012339-1 | NY | Yes |
Addresses
Primary practice location
304 Peconic Ave
Medford, NY 11763-3549
Mailing address
304 Peconic Ave
Medford, NY 11763-3549
Phone (631) 730-5318
Other providers in Medford, NY
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- Rachael Adejaiye
- Isaiah Akinola Adejare
- Kudirat Olufunke Adesanya
- Rebecca A Agosto
- Anna Aiello
- Kehinde M Ajikobi
- Foluke Adesola Akinola
- Adesayo Olawale Akinsanya
- Jyothi Alamuri
All providers in Medford, NY · Speech-Language Pathologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.