MEDICARE: JENNIFER MARIE BELLUOMO M.S., CCC-SLP

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	235Z00000X	Speech-Language Pathologist	021216	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	02126	OTHER	NY	NYS LICENSE #:TEACHER OF STUDENT WITH SPEECH AND LANGUAGE DISORDERS(TSSLD)

General Provider Information

NPI Number	:	1457626699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER MARIE BELLUOMO M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	704 LOCKSLEY RD
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-3135
Country	:	US
Telephone Number	:	914-243-8160
Fax Number	:

Provider Business Practice Location Address
First Line	:	704 LOCKSLEY RD
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-3135
Country	:	US
Telephone Number	:	914-243-8160
Fax Number	:

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

Provider Enumeration Date	:	03/21/2012
Last Update Date	:	11/07/2025

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