Individual provider Active NPI

Amy Ishkanian

  • Speech-Language Pathologist
  • Whitestone, NY
National Provider Identifier
1104250562
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
023879 Issued in NY
Practice address
15715 19TH Ave
Whitestone, NY 11357-3820
Phone
(201) 739-0566
NPI assigned
Aug 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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 023879 NY Primary

Addresses

Primary practice location

15715 19TH Ave
Whitestone, NY 11357-3820

Mailing address

15734 12TH Rd
Beechhurst, NY 11357-1947
Phone (201) 739-0566

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

NPI Registry JSON

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1104250562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15734 12TH RD",
            "city": "BEECHHURST",
            "state": "NY",
            "postal_code": "113571947",
            "telephone_number": "201-739-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15715 19TH AVE",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113573820",
            "telephone_number": "201-739-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHKANIAN",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-21",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "023879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitestone, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; 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.