Provider Demographics
NPI:1487010948
Name:SANTORO, JEANELLE (EDD, CCC-SLPTSSLDBE)
Entity type:Individual
Prefix:DR
First Name:JEANELLE
Middle Name:
Last Name:SANTORO
Suffix:
Gender:F
Credentials:EDD, CCC-SLPTSSLDBE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LARKIN CTR
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-7044
Mailing Address - Country:US
Mailing Address - Phone:212-604-9360
Mailing Address - Fax:
Practice Address - Street 1:1 LARKIN CTR
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-7044
Practice Address - Country:US
Practice Address - Phone:212-604-9360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-13
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028303-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist