Individual provider Active NPI

Ettie Salzman

  • Speech-Language Pathologist
  • Lakewood, NJ
National Provider Identifier
1073924858
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS00746200 Issued in NJ
Practice address
433 Squankum Rd
Lakewood, NJ 08701-2896
Phone
(732) 606-2539
Fax
(732) 901-4749
NPI assigned
May 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 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 41YS00746200 NJ Primary

Addresses

Primary practice location

433 Squankum Rd
Lakewood, NJ 08701-2896

Mailing address

433 Squankum Rd
Lakewood, NJ 08701-2896
Phone (732) 606-2539

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
41YS00746200NJMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Communikids LLC Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1073924858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 SQUANKUM RD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087012896",
            "telephone_number": "732-606-2539",
            "fax_number": "732-901-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 SQUANKUM RD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087012896",
            "telephone_number": "732-606-2539",
            "fax_number": "732-901-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALZMAN",
        "first_name": "ETTIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-14",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00746200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.