Healthcare Provider Details

I. General information

NPI: 1053612416
Provider Name (Legal Business Name): JESSICA HELLMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2010
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15050 14TH RD
WHITESTONE NY
11357-2609
US

IV. Provider business mailing address

515 E 7TH ST STE 201
BROOKLYN NY
11218-4852
US

V. Phone/Fax

Practice location:
  • Phone: 718-767-0071
  • Fax:
Mailing address:
  • Phone: 858-539-9063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number014140
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: