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NPI Code Detail

MEDICARE: JENNIFER CABALLERO MS SLP CCC

MEDICARE:   JENNIFER  CABALLERO  MS SLP CCC
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 Pathologist0233611NY

General Provider Information

NPI Number : 1841733672
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER CABALLERO MS SLP CCC
Provider Business Mailing Address
First Line : 9801 159TH AVE
Second Line :
City : HOWARD BEACH
State : NY
Zip : 11414-3543
Country : US
Telephone Number : 718-659-3140
Fax Number :
Provider Business Practice Location Address
First Line : 9801 159TH AVE
Second Line :
City : HOWARD BEACH
State : NY
Zip : 11414-3543
Country : US
Telephone Number : 718-659-3140
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2016
Last Update Date : 11/30/2016

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Directions to “ JENNIFER CABALLERO MS SLP CCC” Practice Location

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