Provider Demographics
NPI:1871747394
Name:ROSENFELD, JENNIFER RENA (MS, CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:RENA
Last Name:ROSENFELD
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 CENTRAL AVE
Mailing Address - Street 2:APT A203
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1539
Mailing Address - Country:US
Mailing Address - Phone:516-946-9089
Mailing Address - Fax:
Practice Address - Street 1:15645 84TH ST
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-2617
Practice Address - Country:US
Practice Address - Phone:718-738-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-11
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012803-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist