Provider Demographics
NPI:1477046373
Name:FALCO, JESSICA MARIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIE
Last Name:FALCO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 GUARD HILL RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD CORNERS
Mailing Address - State:NY
Mailing Address - Zip Code:10549-4943
Mailing Address - Country:US
Mailing Address - Phone:914-764-9227
Mailing Address - Fax:
Practice Address - Street 1:555 BROADWAY
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-1189
Practice Address - Country:US
Practice Address - Phone:914-674-7340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027158235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist