Individual provider Active NPI

Richard Mugno II, SLP

  • Speech-Language Pathologist
  • Medford, NY
National Provider Identifier
1124351556
Registry record updated Sep 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
018233-1 Issued in NY
Practice address
235 Kettles LN
Medford, NY 11763-1550
Phone
(631) 774-5786
NPI assigned
Sep 17, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2009

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 018233-1 NY Primary

Addresses

Primary practice location

235 Kettles LN
Medford, NY 11763-1550

Mailing address

235 Kettles LN
Medford, NY 11763-1550
Phone (631) 774-5786

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

State licenses

LicenseStateTypeSpecialty
018233-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253145600000",
    "number": "1124351556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 KETTLES LN",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631550",
            "telephone_number": "631-774-5786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 KETTLES LN",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631550",
            "telephone_number": "631-774-5786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUGNO",
        "first_name": "RICHARD",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-17",
        "last_updated": "2009-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "018233-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; 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.