Individual provider Active NPI

Vanessa Lauren Derossi, SLP

  • Speech-Language Pathologist
  • Brooklyn, NY
National Provider Identifier
1073056842
Registry record updated Nov 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
019645-1 Issued in NY
Practice address
8787 24TH Ave
Brooklyn, NY 11214-5309
Phone
(718) 996-6706
NPI assigned
Nov 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 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 019645-1 NY Primary

Addresses

Primary practice location

8787 24TH Ave
Brooklyn, NY 11214-5309

Mailing address

8787 24TH Ave
Brooklyn, NY 11214-5309
Phone (718) 996-6706

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
019645-1NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1073056842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8787 24TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112145309",
            "telephone_number": "718-996-6706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8787 24TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112145309",
            "telephone_number": "718-996-6706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSSI",
        "first_name": "VANESSA",
        "middle_name": "LAUREN",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "019645-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.