Individual provider Active NPI

Leah Fand

  • Speech-Language Pathologist
  • Hoboken, NJ
National Provider Identifier
1124670773
Registry record updated Jul 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS00664500 Issued in NJ
Practice address
1132 Clinton St Apt 614
Hoboken, NJ 07030-3228
Phone
(201) 247-8302
NPI assigned
Jul 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2019

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 41YS00664500 NJ Primary

Addresses

Primary practice location

1132 Clinton St Apt 614
Hoboken, NJ 07030-3228

Mailing address

1132 Clinton St Apt 614
Hoboken, NJ 07030-3228
Phone (201) 247-8302

Other identifiers 1

IdentifierTypeStateIssuer
2012478302OtherNJBLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Leahspeechtherapy.com Direct

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
41YS00664500NJMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1563062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563062400000",
    "number": "1124670773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 CLINTON ST APT 614",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070303228",
            "telephone_number": "201-247-8302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 CLINTON ST APT 614",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070303228",
            "telephone_number": "201-247-8302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAND",
        "first_name": "LEAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-14",
        "last_updated": "2019-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00664500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2012478302",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Leahspeechtherapy.com",
            "affiliation": "N",
            "endpointDescription": "Name",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1132 Clinton St Apt 614",
            "city": "Hoboken",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070303228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2019; 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.