Provider Demographics
NPI:1154632644
Name:KOLLANDER, JENNIFER ELICIA
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ELICIA
Last Name:KOLLANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:ELICIA
Other - Last Name:SELTZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:307 LINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1731
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:999 CENTRAL AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1205
Practice Address - Country:US
Practice Address - Phone:516-374-7914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1181893235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist