Clara Mazepa SLP,P.C.

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

012278 Issued in NY

Legal business name

CLARA MAZEPA SLP,P.C.

Practice address

236 Natick St
Staten Island, NY 10306-1626

Phone

(917) 566-5757

NPI assigned

Oct 30, 2017

Organization subpart

No

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

Authorized official

Name

Clara Mazepa, MA,CCC-SLP,TSHH

Title

President

Phone

(917) 566-5757

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509321600000",
    "number": "1063924058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 NATICK ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10306",
            "telephone_number": "917-566-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 NATICK ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103061626",
            "telephone_number": "917-566-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARA MAZEPA SLP,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-30",
        "last_updated": "2017-10-30",
        "status": "A",
        "authorized_official_last_name": "MAZEPA",
        "authorized_official_first_name": "CLARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-566-5757",
        "authorized_official_credential": "MA,CCC-SLP,TSHH"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "012278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Early Intervention Provider Agency in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2017; 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.