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General NPI Number Information
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NPI Number | 1336370048
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Entity Type | Individual
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Provider Name | JESSICA B LACORTE AUD
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Gender | Female
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Dates
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Enumeration Date | 07/29/2009
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Last Update Date | 03/26/2015
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Provider Practice Location Address
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Address Line | 36A E 36TH ST STE 200 SUITE 200 - NYOG
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City | NEW YORK
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State | NY
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Zip | 10016-3364
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Country | US
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Telephone | 212-889-8575
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Fax | 212-889-0565
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Provider Business Mailing Address
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Address Line | 36 E 36TH ST PH A SUITE 101
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City | NEW YORK
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State | NY
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Zip | 10016-3453
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Country | US
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Telephone | 212-889-8575
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Fax | 212-889-8880
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 0022651
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License Number State | NY
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