Individual provider Active NPI

Cecelia Davidson, PH.D.

  • Speech-Language Pathologist
  • Bronx, NY
National Provider Identifier
1174823744
Registry record updated Aug 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
005806-1 Issued in NY
Practice address
3942 E Tremont Ave
Bronx, NY 10465-2902
Phone
(347) 398-8358
Fax
(347) 398-8359
NPI assigned
Oct 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2011

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 005806-1 NY Primary

Addresses

Primary practice location

3942 E Tremont Ave
Bronx, NY 10465-2902

Mailing address

380 Malcolm X Blvd
Apt. 3C
New York, NY 10027-2381
Phone (914) 912-2329

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
005806-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Links Inc. 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313625600000",
    "number": "1174823744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 MALCOLM X BLVD",
            "address_2": "APT. 3C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100272381",
            "telephone_number": "914-912-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3942 E TREMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104652902",
            "telephone_number": "347-398-8358",
            "fax_number": "347-398-8359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "CECELIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-28",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "005806-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; 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.