Individual provider Active NPI

Jean NG Pack, MA, CCC-SLP, TSHH

  • Speech-Language Pathologist
  • Flushing, NY
National Provider Identifier
1013155985
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
014038-1 Issued in NY
Practice address
16327 26TH Ave
Flushing, NY 11358-1009
Phone
(917) 952-3134
NPI assigned
Jan 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

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 014038-1 NY Primary

Addresses

Primary practice location

16327 26TH Ave
Flushing, NY 11358-1009

Mailing address

16327 26TH Ave
Flushing, NY 11358-1009
Phone (917) 952-3134

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 Arts

State licenses

LicenseStateTypeSpecialty
014038-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1013155985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16327 26TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113581009",
            "telephone_number": "917-952-3134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16327 26TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113581009",
            "telephone_number": "917-952-3134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NG PACK",
        "first_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "MA, CCC-SLP, TSHH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-29",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "014038-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; 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.