Provider Demographics
NPI:1730955204
Name:MORGENSTERN, JASMINE MARIE
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:MARIE
Last Name:MORGENSTERN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 664
Mailing Address - Street 2:
Mailing Address - City:SPEONK
Mailing Address - State:NY
Mailing Address - Zip Code:11972-0664
Mailing Address - Country:US
Mailing Address - Phone:631-310-2689
Mailing Address - Fax:
Practice Address - Street 1:64 NORTH PHILLIPS
Practice Address - Street 2:
Practice Address - City:SPEONK
Practice Address - State:NY
Practice Address - Zip Code:11972
Practice Address - Country:US
Practice Address - Phone:631-310-2689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty