Individual provider Active NPI

Igor Badu, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Hewlett, NY
National Provider Identifier
1104071562
Registry record updated Nov 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
009832-1 Issued in NY
Practice address
53 Bergman Dr
Hewlett, NY 11557-1403
Phone
(516) 569-9069
NPI assigned
Nov 25, 2008
Last updated
Nov 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 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 009832-1 NY Primary

Addresses

Primary practice location

53 Bergman Dr
Hewlett, NY 11557-1403

Mailing address

53 Bergman Dr
Hewlett, NY 11557-1403
Phone (516) 569-9069

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
009832-1NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227571200000",
    "number": "1104071562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 BERGMAN DR",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115571403",
            "telephone_number": "516-569-9069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 BERGMAN DR",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115571403",
            "telephone_number": "516-569-9069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADU",
        "first_name": "IGOR",
        "name_prefix": "Mr.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-25",
        "last_updated": "2008-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "009832-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hewlett, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.