Provider Demographics
NPI:1881823748
Name:KRASNOVSKY, JESSICA (MS, CCC ,SLP)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:KRASNOVSKY
Suffix:
Gender:F
Credentials:MS, CCC ,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 VOORHIS AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-2744
Mailing Address - Country:US
Mailing Address - Phone:516-766-1390
Mailing Address - Fax:
Practice Address - Street 1:62 VOORHIS AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-2744
Practice Address - Country:US
Practice Address - Phone:516-766-1390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-13
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015626235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist