Provider Demographics
NPI:1932554441
Name:HERSH, JENNIFER NEWTON (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:NEWTON
Last Name:HERSH
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 SHERMAN ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-6014
Mailing Address - Country:US
Mailing Address - Phone:718-499-1304
Mailing Address - Fax:
Practice Address - Street 1:17 SHERMAN ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-6014
Practice Address - Country:US
Practice Address - Phone:718-499-1304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist