Provider Demographics
NPI:1659674919
Name:HEALY, JANE M
Entity Type:Individual
Prefix:MISS
First Name:JANE
Middle Name:M
Last Name:HEALY
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 1:246 E 90TH ST
Mailing Address - Street 2:APT 4C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3540
Mailing Address - Country:US
Mailing Address - Phone:917-566-8724
Mailing Address - Fax:
Practice Address - Street 1:246 E 90TH ST
Practice Address - Street 2:APT 4C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3540
Practice Address - Country:US
Practice Address - Phone:917-566-8724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235500000X
NY9769550012355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant