Provider Demographics
NPI:1023331980
Name:ZARETSKY, JILL RENEE (MA, SLP-CCC)
Entity type:Individual
Prefix:MS
First Name:JILL
Middle Name:RENEE
Last Name:ZARETSKY
Suffix:
Gender:F
Credentials:MA, SLP-CCC
Other - Prefix:MS
Other - First Name:JILL
Other - Middle Name:RENEE
Other - Last Name:ZARETSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, SLP-CCC
Mailing Address - Street 1:178 E 80TH ST
Mailing Address - Street 2:APT. 12C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0450
Mailing Address - Country:US
Mailing Address - Phone:917-680-3022
Mailing Address - Fax:
Practice Address - Street 1:178 E 80TH ST
Practice Address - Street 2:APT. 12C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0450
Practice Address - Country:US
Practice Address - Phone:917-680-3022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009111-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist