Healthcare Provider Details

I. General information

NPI: 1366358319
Provider Name (Legal Business Name): JULES BENNETT M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 WESTCHESTER AVE # 304
BRONX NY
10462-5072
US

IV. Provider business mailing address

189 E 93RD ST APT 4A
NEW YORK NY
10128-3740
US

V. Phone/Fax

Practice location:
  • Phone: 718-409-1450
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number124126
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: