Provider Demographics
NPI:1811142995
Name:JAFFEE, SHARAN GAIL (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SHARAN
Middle Name:GAIL
Last Name:JAFFEE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 STONEWALL FARM RD
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-2619
Mailing Address - Country:US
Mailing Address - Phone:914-403-6733
Mailing Address - Fax:
Practice Address - Street 1:54 STONEWALL FARM RD
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-2619
Practice Address - Country:US
Practice Address - Phone:914-403-6733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008332-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist