Provider Demographics
NPI:1023675030
Name:SOLEIMANI, JENNIFER (SLP- CF)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:SOLEIMANI
Suffix:
Gender:F
Credentials:SLP- CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 GILCHREST RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-1404
Mailing Address - Country:US
Mailing Address - Phone:516-303-5798
Mailing Address - Fax:
Practice Address - Street 1:3100 47TH AVE STE 2120
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-3010
Practice Address - Country:US
Practice Address - Phone:718-593-4121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-24
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist