Provider Demographics
NPI:1134659493
Name:JGSLP, P.C.
Entity Type:Organization
Organization Name:JGSLP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MSCCC-SLP/TSSLD
Authorized Official - Phone:646-404-1349
Mailing Address - Street 1:7400 SHORE FRONT PARKWAY
Mailing Address - Street 2:APT SUPT
Mailing Address - City:ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11692-1229
Mailing Address - Country:US
Mailing Address - Phone:646-404-1349
Mailing Address - Fax:
Practice Address - Street 1:7400 SHORE FRONT PARKWAY
Practice Address - Street 2:APT SUPT
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692-1229
Practice Address - Country:US
Practice Address - Phone:646-404-1349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025539235Z00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty