Nicole Ryan Haas

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

027779 Issued in NY

Practice address

1428 5TH Ave
Bay Shore, NY 11706-4147

Phone

(631) 241-3924

NPI assigned

Jun 29, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1013402171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 DARI DR",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414326",
            "telephone_number": "631-241-3924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 5TH AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064147",
            "telephone_number": "631-241-3924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAS",
        "first_name": "NICOLE",
        "middle_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-29",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "027779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Guszack, M.D.
• Yvonne Guzman
• H Avella PMR Medical PC
• H. Tad Troutman, PH.D., Psychologist, PLLC
• Young Ju Ha, R-CSW
• Adah Habib
• Sarven Hacikian, DDS
• Catherine Pennell Haering
• Christine Marie Sheehan Hagemann, M.A.
• Mershad Hagigi, MD, PH.D.

• Speech-Language Pathologist in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.