Active NPI
Tiana Manfred
- Speech-Language Pathologist
- Great Neck, NY
National Provider Identifier
1134523764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 25517 Kensington PL
Great Neck, NY 11020-1054 - Phone
- (646) 641-1461
- NPI assigned
- Oct 10, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
25517 Kensington PL
Great Neck, NY 11020-1054
Mailing address
25517 Kensington PL
Great Neck, NY 11020-1054
Phone (646) 641-1461
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": "1412899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499299200000",
"number": "1134523764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25517 KENSINGTON PL",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110201054",
"telephone_number": "646-641-1461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25517 KENSINGTON PL",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110201054",
"telephone_number": "646-641-1461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANFRED",
"first_name": "TIANA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-10",
"last_updated": "2017-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.