Derrick Laird McGaughey, L.S.P., C.C.C.
Individual provider Active NPI Speech-Language Pathologist · Medina, NY
NPI 1104816099 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1104816099
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 000699 (NY)
- Practice address
- 10520 Maple Ridge Rd
Medina, NY 14103-9512 - Phone
- (585) 735-3335
- NPI assigned
- Oct 24, 2005
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000699 | NY | MD | Dental Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 000699 | NY | Yes |
Addresses
Primary practice location
10520 Maple Ridge Rd
Medina, NY 14103-9512
Mailing address
10520 Maple Ridge Rd
Medina, NY 14103-9512
Phone (585) 735-3335
Other providers in Medina, NY
- Thomas J Madejski
- Cindy Michelle Marzan
- Debra Lynn Mattoon
- Richard F Matuszak
- Amanda Ann McDonald
- Kelly Deann McMurray
- Medina Central School District
- Medina Dental PLLC
- Medina Optical Fashions, Inc.
- Medina Transport Taxi LLC
All providers in Medina, NY · Speech-Language Pathologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.