Individual provider Active NPI

Katherine Canonico, M.S., CCC-SLP, TSSLD

  • Speech-Language Pathologist
  • Bronx, NY
National Provider Identifier
1003115791
Registry record updated Jul 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
020234-1 Issued in NY
Practice address
369 E 148TH St
Lower Level
Bronx, NY 10455-4041
Phone
(718) 769-2698
Fax
(718) 769-2317
NPI assigned
Mar 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 020234-1 NY Primary

Addresses

Primary practice location

369 E 148TH St
Lower Level
Bronx, NY 10455-4041

Mailing address

240 E 85TH St Apt 4B
New York, NY 10028-3048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
020234-1NYMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373328000000",
    "number": "1003115791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 E 85TH ST APT 4B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100283048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 E 148TH ST",
            "address_2": "LOWER LEVEL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104554041",
            "telephone_number": "718-769-2698",
            "fax_number": "718-769-2317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANONICO",
        "first_name": "KATHERINE",
        "credential": "M.S., CCC-SLP, TSSLD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-21",
        "last_updated": "2013-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "020234-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.