Individual provider Active NPI

Cassandra Dantzler

  • Speech-Language Pathologist
  • Jamaica, NY
National Provider Identifier
1043754971
Registry record updated Dec 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
636520 Issued in NY
Practice address
12520 Sutphin Blvd
Jamaica, NY 11434-2340
Phone
(718) 558-2900
Fax
(718) 925-9020
NPI assigned
Dec 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2016

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 636520 NY Primary

Addresses

Primary practice location

12520 Sutphin Blvd
Jamaica, NY 11434-2340

Mailing address

12520 Sutphin Blvd
Jamaica, NY 11434-2340
Phone (718) 558-2900

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
636520NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1043754971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12520 SUTPHIN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114342340",
            "telephone_number": "718-558-2900",
            "fax_number": "718-925-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12520 SUTPHIN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114342340",
            "telephone_number": "718-558-2900",
            "fax_number": "718-925-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANTZLER",
        "first_name": "CASSANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-12",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "636520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; 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.