Individual provider Active NPI

Jacquilyn Polara, M.S.,CCC-SLP

  • Speech-Language Pathologist
  • Huntingdon Valley, PA
National Provider Identifier
1043617228
Registry record updated Dec 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL012129 Issued in PA
Practice address
426 Meadowbrook Dr
Huntingdon Valley, PA 19006-6825
Phone
(516) 668-2326
NPI assigned
Dec 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2014

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 SL012129 PA Primary

Addresses

Primary practice location

426 Meadowbrook Dr
Huntingdon Valley, PA 19006-6825

Mailing address

426 Meadowbrook Dr
Huntingdon Valley, PA 19006-6825
Phone (516) 668-2326

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 Science

State licenses

LicenseStateTypeSpecialty
SL012129PAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417564800000",
    "number": "1043617228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 MEADOWBROOK DR",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190066825",
            "telephone_number": "516-668-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 MEADOWBROOK DR",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190066825",
            "telephone_number": "516-668-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLARA",
        "first_name": "JACQUILYN",
        "credential": "M.S.,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-03",
        "last_updated": "2014-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL012129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntingdon Valley, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; 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.