Provider Demographics
NPI:1164870432
Name:VALLEJO, JHOJAIRA LISET
Entity Type:Individual
Prefix:
First Name:JHOJAIRA
Middle Name:LISET
Last Name:VALLEJO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 ASCH LOOP
Mailing Address - Street 2:APT: 25F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-4002
Mailing Address - Country:US
Mailing Address - Phone:917-324-7719
Mailing Address - Fax:
Practice Address - Street 1:329 E 149TH ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5601
Practice Address - Country:US
Practice Address - Phone:718-769-2698
Practice Address - Fax:718-292-0208
Is Sole Proprietor?:No
Enumeration Date:2016-05-27
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator