Provider Demographics
NPI:1790047538
Name:KATEMAN, JENNIFER MELISSA (MA)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:MELISSA
Last Name:KATEMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 NOME AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6016
Mailing Address - Country:US
Mailing Address - Phone:732-407-5863
Mailing Address - Fax:
Practice Address - Street 1:288 NOME AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6016
Practice Address - Country:US
Practice Address - Phone:732-407-5863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021458235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist