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Jessica Ann Mazzotta

Speech-Language Pathologist, in Bayside, NY. Individual provider (NPI-1).

NPI number1114408564
StatusActive
Last updated in NPPESNov 2, 2021

Details

NPI
1114408564
Entity type
Individual (NPI-1)
Name
Miss Jessica Ann Mazzotta
Sex
Female
Sole proprietor
No
Enumeration date
Aug 23, 2018
Certification date
Nov 2, 2021
Last updated
Nov 2, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,––Yes

Practice location

2901 216th St
Bayside, NY 11360-2899

Phone 718-281-8800

Mailing address

126 Agor Ln
Mahopac, NY 10541-1324

Phone 845-519-8780

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