Healthcare Provider Details

I. General information

NPI: 1326446170
Provider Name (Legal Business Name): JESSICA TAYLOR POTTER AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2014
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2317 BALLTOWN RD STE 104
SCHENECTADY NY
12309-2344
US

IV. Provider business mailing address

950 ROUTE 146 STE 200
CLIFTON PARK NY
12065-3667
US

V. Phone/Fax

Practice location:
  • Phone: 518-381-4650
  • Fax: 518-381-4156
Mailing address:
  • Phone: 518-383-4273
  • Fax: 518-383-4274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number002524-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number002524-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: