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Contact Information

JENNIFER A PETRUSKI, MSED, CCC-SLP
345 MOUNTAIN VIEW AVE
PORT EWEN, NY12466
 Phone: 845-943-3431
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
Indicates primary specialty

NPI Profile & details for JENNIFER A PETRUSKI · (Female)

NPI # 1497023626
Status Active
Credentials MSED, CCC-SLP
Entity Individual
Enumeration date 12/02/2011
Last updated 12/02/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 008165-1
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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