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NPI Code Detail

MEDICARE: DRUCILLA JIMENEZ

MEDICARE: DRUCILLA JIMENEZ
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 Pathologist

General Provider Information

NPI Number : 1972043438
Entity Type Code : Individual
Provider Name (Legal Business Name) : DRUCILLA JIMENEZ
Provider Business Mailing Address
First Line : 85 GLEN DR
Second Line :
City : KEASBEY
State : NJ
Zip : 08832-1128
Country : US
Telephone Number : 914-318-8104
Fax Number :
Provider Business Practice Location Address
First Line : 2 GRIDLEY AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10303-2204
Country : US
Telephone Number : 718-448-7774
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2017
Last Update Date : 03/03/2017

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Directions to “ DRUCILLA JIMENEZ ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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