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General NPI Number Information
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NPI Number | 1255779617
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Entity Type | Individual
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Provider Name | YENIFER JOYA ROCHA MS, SLP, TSSLD -BEA
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Gender | Female
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Dates
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Enumeration Date | 06/07/2013
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 12510 QUEENS BLVD STE 218
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City | KEW GARDENS
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State | NY
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Zip | 11415-1506
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Country | US
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Telephone | 718-593-4121
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Fax | 718-268-2646
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Provider Business Mailing Address
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Address Line | 312 BEACH 89TH ST APT 3
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City | ROCKAWAY BEACH
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State | NY
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Zip | 11693-1404
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Country | US
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Telephone | 929-888-1134
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 023747-01
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License Number State | NY
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