Jennifer Ann Mollica, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

58008791 Issued in NY

Practice address

210A Spruce St
Massapequa Park, NY 11762-1758

Phone

(516) 308-5501

NPI assigned

Dec 20, 2011

Last updated

Dec 20, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1932478013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210A SPRUCE ST",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117621758",
            "telephone_number": "516-308-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210A SPRUCE ST",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117621758",
            "telephone_number": "516-308-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLICA",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-20",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "58008791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58008791",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sean Thomas Miller
• William Milton
• Adrienne Mogavero, LMSW
• Allan Mohr, DDS
• Linda Moleta, MS
• Holly Moore
• Tiffany Juliana Mordente
• Donna Morey
• Marlene C Morrow, M.A.
• Josie C Mott, MSCCC/SLP

• Speech-Language Pathologist in Massapequa Park, NY
• Providers in Massapequa Park, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; 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.