1306059571 NPI number — MRS. JACQUELINE KAREN MOJICA MS, CCC-SLP

Table of content: MRS. JACQUELINE KAREN MOJICA MS, CCC-SLP (NPI 1306059571)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306059571 NPI number — MRS. JACQUELINE KAREN MOJICA MS, CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOJICA
Provider First Name:
JACQUELINE
Provider Middle Name:
KAREN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS, CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHAEFER
Provider Other First Name:
JACQUELINE
Provider Other Middle Name:
KAREN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, CCC-SLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1306059571
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
106 JEFFERSON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROSLYN HEIGHTS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11577-2029
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-621-4375
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 UNION SQ E
Provider Second Line Business Practice Location Address:
SUITE 5B
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10003-3314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-844-8775
Provider Business Practice Location Address Fax Number:
212-844-6976
Provider Enumeration Date:
05/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  006341 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com