Provider Demographics
NPI:1073843363
Name:WIND, JENNIFER SARA (AUD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SARA
Last Name:WIND
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:S
Other - Last Name:WEITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:560 WHITE PLAINS ROAD
Mailing Address - Street 2:SUITE 615 ENTA
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10959-6802
Mailing Address - Country:US
Mailing Address - Phone:914-333-5801
Mailing Address - Fax:
Practice Address - Street 1:560 WHITE PLAINS ROAD
Practice Address - Street 2:SUITE 615 ENTA
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10959-6802
Practice Address - Country:US
Practice Address - Phone:914-333-5801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-08
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002343231H00000X
FLAY1692231H00000X
NY14000029876237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist