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NPI Code Detail

MEDICARE: JENNIFER BULZONE CCC-SLP

MEDICARE: JENNIFER BULZONE 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 Pathologist016730NY

General Provider Information

NPI Number : 1992018824
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER BULZONE CCC-SLP
Provider Business Mailing Address
First Line : 38 SANDY LN
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10307-2311
Country : US
Telephone Number : 718-227-5273
Fax Number :
Provider Business Practice Location Address
First Line : 3936 AMBOY RD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10308-2406
Country : US
Telephone Number : 718-317-6390
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2010
Last Update Date : 07/20/2010

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Directions to “ JENNIFER BULZONE CCC-SLP” Practice Location

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