Provider Demographics
NPI:1891281978
Name:VERKHOVSKY, JESSICA ANN (AUD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:VERKHOVSKY
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 1:660 WHITE PLAINS ROAD - ENTA
Mailing Address - Street 2:FOURTH FLOOR
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-6802
Mailing Address - Country:US
Mailing Address - Phone:914-984-2552
Mailing Address - Fax:
Practice Address - Street 1:107-21 QUEENS BOULEVARD
Practice Address - Street 2:SUITE 8
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:718-575-0777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002788231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist