Provider Demographics
NPI:1710435375
Name:NOSKA, JENNIE (AUD)
Entity Type:Individual
Prefix:
First Name:JENNIE
Middle Name:
Last Name:NOSKA
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 1:654 MADISON AVE RM 709
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8438
Mailing Address - Country:US
Mailing Address - Phone:212-486-7538
Mailing Address - Fax:
Practice Address - Street 1:654 MADISON AVE RM 709
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8438
Practice Address - Country:US
Practice Address - Phone:212-486-7538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002680-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY002680-1OtherLICENSE