Basic Information
| Provider Information | |||||||||
| NPI: | 1225345655 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ABRAMS | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | SANCHEZ | ||||||||
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| Credential: | MA, SLP-CCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 43-09 104 ST | ||||||||
| Address2: | |||||||||
| City: | CORONA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11368 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187670091 | ||||||||
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| Practice Location | |||||||||
| Address1: | 15050 14TH RD | ||||||||
| Address2: | C/O ALL IN 1 SPOT | ||||||||
| City: | WHITESTONE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113572607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187670091 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2010 | ||||||||
| LastUpdateDate: | 11/21/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 019517-1 | NY | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | 1240918 | NY | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.