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NPI Code Detail

MEDICARE: JENNA MARIE PREGO M.S., CCC-SLP

MEDICARE: JENNA MARIE PREGO 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
1235Z00000XSpeech-Language Pathologist022712-1NY

General Provider Information

NPI Number : 1801266317
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA MARIE PREGO M.S., CCC-SLP
Provider Business Mailing Address
First Line : 192 TOWER DR
Second Line : SUITE 400
City : MIDDLETOWN
State : NY
Zip : 10941-2056
Country : US
Telephone Number : 845-692-4391
Fax Number :
Provider Business Practice Location Address
First Line : 815 BLOOMING GROVE TPKE STE 601
Second Line :
City : NEW WINDSOR
State : NY
Zip : 12553-8138
Country : US
Telephone Number : 845-527-2089
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2015
Last Update Date : 01/16/2024

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