Individual provider Active NPI

Roshanda Nicole Neal, MS.ED

  • Specialist
  • Syosset, NY
National Provider Identifier
1063776185
Registry record updated Jul 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
836691 Issued in NY
Practice address
47 Humphrey Dr
Syosset, NY 11791-4022
Phone
(516) 921-7171
NPI assigned
Jul 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 836691 NY Primary
Specialist 174400000X 1880802 NY

Addresses

Primary practice location

47 Humphrey Dr
Syosset, NY 11791-4022

Mailing address

39 Summer Ave
Great Neck, NY 11020-1525
Phone (516) 582-8978

Other identifiers 2

IdentifierTypeStateIssuer
1880802OtherNYCHILDHOOD 1-6 TEACHER CERTIFICATION
836691OtherNYBIRTH-2 TEACHER CERTIFICATION

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
1880802NYMDSpecialist
836691NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341273600000",
    "number": "1063776185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 SUMMER AVE",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110201525",
            "telephone_number": "516-582-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 HUMPHREY DR",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914022",
            "telephone_number": "516-921-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "ROSHANDA",
        "middle_name": "NICOLE",
        "credential": "MS.ED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-03",
        "last_updated": "2012-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "836691",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1880802",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILDHOOD 1-6 TEACHER CERTIFICATION",
            "identifier": "1880802",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BIRTH-2 TEACHER CERTIFICATION",
            "identifier": "836691",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; 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.