Individual provider Active NPI

Diane Wiener, SLP

  • Speech-Language Pathologist
  • Astoria, NY
National Provider Identifier
1073793659
Registry record updated Oct 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
004518-1 Issued in NY
Practice address
2534 Steinway St
Astoria, NY 11103-3702
Phone
(718) 777-5243
Fax
(718) 777-5250
NPI assigned
Nov 12, 2007
Last updated
Oct 2, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 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 004518-1 NY Primary

Addresses

Primary practice location

2534 Steinway St
Astoria, NY 11103-3702

Mailing address

7 Steeplechase Dr
Marlboro, NJ 07746-1909
Phone (732) 308-9577

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
004518-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Welllife Network Inc Past Accepting new patients
Welllife Network Inc., Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254441600000",
    "number": "1073793659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 STEEPLECHASE DR",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077461909",
            "telephone_number": "732-308-9577",
            "fax_number": "732-308-1417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2534 STEINWAY ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111033702",
            "telephone_number": "718-777-5243",
            "fax_number": "718-777-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIENER",
        "first_name": "DIANE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-12",
        "last_updated": "2009-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "004518-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.