Mordechai Lichtenstadter, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

019660 Issued in NY

Practice address

5201 14TH Ave
#6-D
Brooklyn, NY 11219-3972

Phone

(718) 851-9079

NPI assigned

Sep 7, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Premium Health Inc

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
  • NPI 1609129402
  NPD (past)

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1093022485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 14TH AVE",
            "address_2": "#6-D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112193972",
            "telephone_number": "718-851-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 14TH AVE",
            "address_2": "#6-D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112193972",
            "telephone_number": "718-851-9079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTENSTADTER",
        "first_name": "MORDECHAI",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-07",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "019660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE#",
            "identifier": "019660",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Jerome Licht, D.D.S.
• Devorah Lichtenfeld
• Michelle Lichtenfeld, MS SPED
• Aaron Lichtenstadter, LMHC
• Dovid Lichtenstadter
• Avigayil Lichtenstein
• Chana Malkie Lichtenstein
• Chaya Lichtenstein
• Chaya Lichtenstein
• Esther Lichtenstein

• Speech-Language Pathologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; 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.