Provider Demographics
NPI:1336370048
Name:LACORTE, JESSICA B (AUD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:B
Last Name:LACORTE
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 1:36 E 36TH ST PH A
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3453
Mailing Address - Country:US
Mailing Address - Phone:212-889-8575
Mailing Address - Fax:212-889-8880
Practice Address - Street 1:36A E 36TH ST STE 200
Practice Address - Street 2:SUITE 200 - NYOG
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3364
Practice Address - Country:US
Practice Address - Phone:212-889-8575
Practice Address - Fax:212-889-0565
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0022651231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist