Provider Demographics
NPI:1720396377
Name:LAMORTE, JACLYN ROSE (MS)
Entity Type:Individual
Prefix:MS
First Name:JACLYN
Middle Name:ROSE
Last Name:LAMORTE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MONROE PL
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6914
Mailing Address - Country:US
Mailing Address - Phone:917-733-3819
Mailing Address - Fax:
Practice Address - Street 1:8 MONROE PL
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6914
Practice Address - Country:US
Practice Address - Phone:917-733-3819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist