MEDICARE: JESSICA SARAH CRISCI AU.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	002827	NY

General Provider Information

NPI Number	:	1083190342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA SARAH CRISCI AU.D.

Provider Business Mailing Address
First Line	:	560 WHITE PLAINS RD STE 615
Second Line	:
City	:	TARRYTOWN
State	:	NY
Zip	:	10591-6802
Country	:	US
Telephone Number	:	914-333-5801
Fax Number	:

Provider Business Practice Location Address
First Line	:	990 STEWART AVE STE 610
Second Line	:
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-4838
Country	:	US
Telephone Number	:	516-280-1701
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2018
Last Update Date	:	09/19/2024

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