Individual provider Active NPI

Yeji Park

  • Speech-Language Pathologist
  • Fort Lee, NJ
National Provider Identifier
1003539693
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
2460 Lemoine Ave Ste 502
Fort Lee, NJ 07024-6210
Phone
(201) 419-6114
NPI assigned
Sep 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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 Primary

Addresses

Primary practice location

2460 Lemoine Ave Ste 502
Fort Lee, NJ 07024-6210

Mailing address

2 S Constitution Dr
Tappan, NY 10983-1619

Other practice location 1

535 5th Ave Fl 4
New York, NY 10017-8020
Phone (718) 948-1900

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

Practice roles

OrganizationSpecialtyStatusNew patients
Italk Speech & Language Center Speech-Language Pathologist CurrentSince Aug 17, 2025 Accepting new patients
Italk Speech Language Pathology PLLC Speech-Language Pathologist PastSince Aug 17, 2025 Accepting new patients

Locations

2460 Lemoine Ave
Ste 502
Fort Lee, NJ 07024
Phone (201) 419-6114

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1003539693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 S CONSTITUTION DR",
            "city": "TAPPAN",
            "state": "NY",
            "postal_code": "109831619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 LEMOINE AVE STE 502",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246210",
            "telephone_number": "201-419-6114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 5th Ave Fl 4",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100178020",
            "country_code": "US",
            "telephone_number": "718-948-1900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "YEJI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-20",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; 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.