Individual provider Active NPI

Zeynep Fresolone

  • Speech-Language Pathologist
  • Wyckoff, NJ
National Provider Identifier
1003377482
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS00960000 Issued in NJ
Practice address
301 Sicomac Ave
Wyckoff, NJ 07481-2159
Phone
(201) 848-5200
NPI assigned
Mar 27, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 41YS00960000 NJ Primary

Addresses

Primary practice location

301 Sicomac Ave
Wyckoff, NJ 07481-2159

Mailing address

20-44 Calyne Dr
Fair Lawn, NJ 07410-2703
Phone (973) 570-4359

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

State licenses

LicenseStateTypeSpecialty
41YS00960000NJMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1003377482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20-44 CALYNE DR",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102703",
            "telephone_number": "973-570-4359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SICOMAC AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074812159",
            "telephone_number": "201-848-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRESOLONE",
        "first_name": "ZEYNEP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00960000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyckoff, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; 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.