Active NPI
Jennifer Marie White, M.S., CCC-SLP
- Speech-Language Pathologist
- Glen Head, NY
National Provider Identifier
1174793178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 017296-1
- Practice address
- 189 Wheatley Rd
Glen Head, NY 11545-2641 - Phone
- (516) 626-1075
- NPI assigned
- Mar 5, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 017296-1 | NY | Primary |
Addresses
Primary practice location
189 Wheatley Rd
Glen Head, NY 11545-2641
Mailing address
2 North CT
Mount Sinai, NY 11766-3123
Phone (631) 509-0726
Other names 1
- Ms. Jennifer Marie Blaszkow
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017296-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655078400000",
"number": "1174793178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 NORTH CT",
"city": "MOUNT SINAI",
"state": "NY",
"postal_code": "117663123",
"telephone_number": "631-509-0726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "189 WHEATLEY RD",
"city": "GLEN HEAD",
"state": "NY",
"postal_code": "115452641",
"telephone_number": "516-626-1075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "JENNIFER",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-05",
"last_updated": "2022-06-13",
"certification_date": "2022-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "017296-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "BLASZKOW",
"middle_name": "MARIE",
"prefix": "MS.",
"credential": "M.S., CCC-SLP",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Glen Head, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.