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General NPI Number Information
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NPI Number | 1629503446
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Entity Type | Individual
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Provider Name | JENNIFER GRADOS MS, CCC-SLP TSSLD
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Gender | Female
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Dates
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Enumeration Date | 04/30/2017
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 300 CORPORATE BLVD S
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City | YONKERS
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State | NY
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Zip | 10701-6862
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Country | US
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Telephone | 833-637-3866
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Fax |
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Provider Business Mailing Address
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Address Line | 2027 CRESCENT DR
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City | TARRYTOWN
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State | NY
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Zip | 10591-5869
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Country | US
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Telephone | 917-628-9425
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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