Provider Demographics
NPI:1518276286
Name:JAFFE, DENISE A (MS, CCC)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:A
Last Name:JAFFE
Suffix:
Gender:F
Credentials:MS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 FAR HILL LN
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-2524
Mailing Address - Country:US
Mailing Address - Phone:914-747-0721
Mailing Address - Fax:914-747-0722
Practice Address - Street 1:16 FAR HILL LN
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570-2524
Practice Address - Country:US
Practice Address - Phone:914-747-0721
Practice Address - Fax:914-747-0722
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000402-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist