Jenna Elizabeth Bertan | Staten Island, NY • PECOS Search

Jenna Elizabeth Bertan

Speech-Language Pathologist

Speech, Language and Hearing Service Providers

930 Willowbrook Rd, Staten Island, NY 10314-4281

(718) 494-7542 (718) 317-2311

PECOS Enrollment

Based on the most recent information from CMS, provider Jenna Elizabeth Bertan does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1952453078
Provider Type
Individual
Full Name
Bertan, Jenna Elizabeth
Title
Mrs.
Credential
CCCSLP

Gender
Female
Sole Proprietor
No
Enumeration Date
1/17/2007
Last Updated
7/8/2007

Contact Information

Practice Location

930 Willowbrook Rd, Staten Island, NY 10314-4281

Unlisted Fax

Mailing Location

273 Great Kills Rd, Staten Island, NY 10308-3216

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 235Z00000X Primary	Description Speech-Language Pathologist Speech, Language and Hearing Service Providers	License 014056 New York