Individual provider Active NPI

Stella H Eracleous-Kyprianou

  • Speech-Language Pathologist
  • New York, NY
National Provider Identifier
1144460205
Registry record updated Mar 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
016364-1 Issued in NY
Practice address
353 Fort Washington Ave
Suite 1E
New York, NY 10033-6701
Phone
(212) 928-1222
Fax
(866) 688-4675
NPI assigned
Mar 3, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 016364-1 NY Primary
Speech-Language Pathologist 235Z00000X 41YS00587100 NJ

Addresses

Primary practice location

353 Fort Washington Ave
Suite 1E
New York, NY 10033-6701

Mailing address

135 Rockland Ave
Northvale, NJ 07647-2113
Phone (201) 750-3234

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
41YS00587100NJMDSpeech-Language Pathologist
016364-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Logopedica LLC Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236038400000",
    "number": "1144460205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 ROCKLAND AVE",
            "city": "NORTHVALE",
            "state": "NJ",
            "postal_code": "076472113",
            "telephone_number": "201-750-3234",
            "fax_number": "866-688-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 FORT WASHINGTON AVE",
            "address_2": "SUITE 1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100336701",
            "telephone_number": "212-928-1222",
            "fax_number": "866-688-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERACLEOUS-KYPRIANOU",
        "first_name": "STELLA",
        "middle_name": "H",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-03",
        "last_updated": "2009-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "016364-1",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00587100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.