Individual provider Active NPI

Jennifer V. Wasserberg

  • Speech-Language Pathologist
  • White Plains, NY
National Provider Identifier
1033480710
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1258422 Issued in NY
Practice address
167 Greenridge Ave
White Plains, NY 10605-3217
Phone
(914) 498-0516
NPI assigned
Jan 26, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2021

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 1258422 NY Primary

Addresses

Primary practice location

167 Greenridge Ave
White Plains, NY 10605-3217

Mailing address

167 Greenridge Ave
White Plains, NY 10605-3217
Phone (914) 498-0516

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
1258422NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1033480710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 GREENRIDGE AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106053217",
            "telephone_number": "914-498-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 GREENRIDGE AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106053217",
            "telephone_number": "914-498-0516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERBERG",
        "first_name": "JENNIFER",
        "middle_name": "V.",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-26",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "1258422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.