Individual provider Active NPI

Patricia Tancredi, MA-CCC/SLP

  • Speech-Language Pathologist
  • Brielle, NJ
National Provider Identifier
1104004977
Registry record updated Feb 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS00246800 Issued in NJ
Practice address
27A Brandywyne
Brielle, NJ 08730-1323
Phone
(609) 290-5658
NPI assigned
Feb 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2008

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 41YS00246800 NJ Primary

Addresses

Primary practice location

27A Brandywyne
Brielle, NJ 08730-1323

Mailing address

27A Brandywyne
Brielle, NJ 08730-1323
Phone (609) 290-5658

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202083200000",
    "number": "1104004977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27A BRANDYWYNE",
            "city": "BRIELLE",
            "state": "NJ",
            "postal_code": "087301323",
            "telephone_number": "609-290-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27A BRANDYWYNE",
            "city": "BRIELLE",
            "state": "NJ",
            "postal_code": "087301323",
            "telephone_number": "609-290-5658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANCREDI",
        "first_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "MA-CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-04",
        "last_updated": "2008-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00246800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brielle, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2008; 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.