Provider Demographics
NPI:1053601260
Name:PARLANTE, JENNIFER LYN (MS)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYN
Last Name:PARLANTE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 CALDWELL ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-1821
Mailing Address - Country:US
Mailing Address - Phone:631-547-0095
Mailing Address - Fax:
Practice Address - Street 1:75 CALDWELL ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-1821
Practice Address - Country:US
Practice Address - Phone:631-547-0095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-10
Last Update Date:2011-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY080784011252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency