Provider Demographics
NPI:1457164063
Name:SYNOSKY, JILLIAN M (SLP)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:M
Last Name:SYNOSKY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 ROUTE 70 E STE 1
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2141
Mailing Address - Country:US
Mailing Address - Phone:609-696-5929
Mailing Address - Fax:
Practice Address - Street 1:1940 ROUTE 70 E STE 1
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2141
Practice Address - Country:US
Practice Address - Phone:609-696-5929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00954300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist