Individual provider Active NPI

Hadassa Nicole Bobker, MS CCC/SLP

  • Speech-Language Pathologist
  • Lawrence, NY
National Provider Identifier
1073749362
Registry record updated Jun 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
012495 Issued in NY
Practice address
2 Holly LN
Lawrence, NY 11559-1317
Phone
(516) 371-9592
NPI assigned
Jun 1, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2009

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 012495 NY Primary

Addresses

Primary practice location

2 Holly LN
Lawrence, NY 11559-1317

Mailing address

2 Holly LN
Lawrence, NY 11559-1317
Phone (516) 371-9592

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
012495NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243814400000",
    "number": "1073749362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 HOLLY LN",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591317",
            "telephone_number": "516-371-9592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 HOLLY LN",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591317",
            "telephone_number": "516-371-9592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBKER",
        "first_name": "HADASSA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "MS CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-01",
        "last_updated": "2009-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "012495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2009; 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.