Jennifer Pedicone, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS00918300 Issued in NJ

Practice address

1501 Hamburg Tpke
Wayne, NJ 07470-4032

Phone

(973) 800-8515

NPI assigned

May 31, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brave Wings Academy, LLP

  • Behavior Analyst
  • Fairfield, NJ
  • NPI 1114629177
  NPD (past)
• Brave Wings Therapy, PC

  • Multi-Specialty Clinic/Center
  • Fairfield, NJ
  • NPI 1497304430

  Speech-Language Pathologist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1447742937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 ROOSEVELT PL APT 41",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HAMBURG TPKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074704032",
            "telephone_number": "973-800-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDICONE",
        "first_name": "JENNIFER",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-31",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00918300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Pavlik, LCSW
• Klaudia Pazowski
• Pediatric Ophthalmology of NJ, P.C.
• Pediatric Professional Associates, PA
• Pediatric Rehabilitation of North Jersey PC
• Caitlin Rose Peltyszyn, PT, DPT
• Betsy Pendexter, R.N., A.P.N.
• Gary Pepe, M.D.
• Michael J Pereira, MD
• Ada Perez

• Speech-Language Pathologist in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.