Active NPI
Lauren Nicole Bostwick, M.S.ED
- Speech-Language Pathologist
- Blossvale, NY
National Provider Identifier
1104501543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 8564 State Route 13
Blossvale, NY 13308-3419 - Phone
- (315) 245-3412
- NPI assigned
- Jun 21, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | NY | Primary |
Addresses
Primary practice location
8564 State Route 13
Blossvale, NY 13308-3419
Mailing address
109 Wakefield LN
Ava, NY 13303-1816
Phone (315) 790-0495
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": "1687305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687305600000",
"number": "1104501543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 WAKEFIELD LN",
"city": "AVA",
"state": "NY",
"postal_code": "133031816",
"telephone_number": "315-790-0495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8564 STATE ROUTE 13",
"city": "BLOSSVALE",
"state": "NY",
"postal_code": "133083419",
"telephone_number": "315-245-3412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSTWICK",
"first_name": "LAUREN",
"middle_name": "NICOLE",
"name_prefix": "Miss",
"credential": "M.S.ED",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-21",
"last_updated": "2023-06-21",
"certification_date": "2023-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Blossvale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.