Provider Demographics
NPI:1659912681
Name:PERTNOY, JARETT ALEX
Entity Type:Individual
Prefix:
First Name:JARETT
Middle Name:ALEX
Last Name:PERTNOY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5458 TOWN CENTER RD STE 104
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1026
Mailing Address - Country:US
Mailing Address - Phone:561-600-9692
Mailing Address - Fax:561-961-5899
Practice Address - Street 1:5458 TOWN CENTER RD STE 104
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1026
Practice Address - Country:US
Practice Address - Phone:561-600-9692
Practice Address - Fax:561-961-5899
Is Sole Proprietor?:No
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist