Provider Demographics
NPI:1639488471
Name:COFONI, JESSICA ANN (AUD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:COFONI
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 ROUTE 22
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2560
Mailing Address - Country:US
Mailing Address - Phone:908-722-1022
Mailing Address - Fax:908-722-1022
Practice Address - Street 1:245 ROUTE 22
Practice Address - Street 2:SUITE 300
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2560
Practice Address - Country:US
Practice Address - Phone:908-722-1022
Practice Address - Fax:908-722-1022
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001441237600000X
NJ41YA00078900231H00000X
NJ25MG00122000237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter