Jennifer Gillanders, SLP
Individual provider Active NPI Speech-Language Pathologist · Bayport, NY
NPI 1942472014 · NPPES record last updated Mar 29, 2008
Key facts
- NPI
- 1942472014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Practice address
- 481 Middle Rd
Bayport, NY 11705-1907 - Phone
- (631) 868-0736
- NPI assigned
- Mar 29, 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | NY | Yes |
Addresses
Primary practice location
481 Middle Rd
Bayport, NY 11705-1907
Mailing address
481 Middle Rd
Bayport, NY 11705-1907
Phone (631) 868-0736
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All providers in Bayport, 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 Mar 29, 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.