Provider Demographics
NPI:1063648913
Name:FALERO, JASMINE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:FALERO
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10107 98TH ST
Mailing Address - Street 2:APARTMENT 2R
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11416-2524
Mailing Address - Country:US
Mailing Address - Phone:347-351-8798
Mailing Address - Fax:
Practice Address - Street 1:10107 98TH ST
Practice Address - Street 2:APARTMENT 2R
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11416-2524
Practice Address - Country:US
Practice Address - Phone:347-351-8798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017698235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist