Active NPI
Michelle Ellen Dattoli, MA, CCC-SLP
- Speech-Language Pathologist
- New Hyde Park, NY
National Provider Identifier
1154592855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 010443-1
- Practice address
- 430 Lakeville Rd
New Hyde Park, NY 11042-1121 - Phone
- (718) 470-8910
- Fax
- (718) 347-8241
- NPI assigned
- Mar 20, 2008
- Sex
- Female
- Sole proprietor
- No
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 | 010443-1 | NY | Primary |
Addresses
Primary practice location
430 Lakeville Rd
New Hyde Park, NY 11042-1121
Mailing address
430 Lakeville Rd
New Hyde Park, NY 11042-1121
Phone (718) 470-8910
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010443-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205971200000",
"number": "1154592855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 LAKEVILLE RD",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110421121",
"telephone_number": "718-470-8910",
"fax_number": "718-347-8241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 LAKEVILLE RD",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110421121",
"telephone_number": "718-470-8910",
"fax_number": "718-347-8241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DATTOLI",
"first_name": "MICHELLE",
"middle_name": "ELLEN",
"name_prefix": "Mrs.",
"credential": "MA, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-20",
"last_updated": "2008-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "010443-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New Hyde Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.