Provider Demographics
NPI:1053618850
Name:REESE, JENNIFER E
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
Last Name:REESE
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 1:200 E 72ND ST
Mailing Address - Street 2:APT 20M
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4537
Mailing Address - Country:US
Mailing Address - Phone:973-868-4538
Mailing Address - Fax:
Practice Address - Street 1:200 E 72ND ST
Practice Address - Street 2:APT 20M
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4537
Practice Address - Country:US
Practice Address - Phone:973-868-4538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-15
Last Update Date:2013-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist