Debra Elaine Moore, MACCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

00959650 Issued in NY

Practice address

17 Mills LN
East Setauket, NY 11733-3805

Phone

(631) 751-3838

NPI assigned

Feb 19, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Speech Language Place, SLP, PC

  • Speech-Language Pathologist
  • Stony Brook, NY
  • NPI 1114159464
  NPD (past)

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

{
    "created_epoch": "1361232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1174863765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 HALLOCK RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903033",
            "telephone_number": "631-751-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 MILLS LN",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333805",
            "telephone_number": "631-751-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DEBRA",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "MACCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-19",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "00959650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Montana, D.O.
• Denise Monte, M.D.
• Patricia Montes, ANP
• Farah Monzur, MD
• Sean Moonsammy
• Milagro Morales
• Brian Nicholas Morelli, MD
• Jeanine Murphy Morelli, MD
• Grisel Moreno, OTR
• Morgan N. Chen M.D. P.C.

• Speech-Language Pathologist in East Setauket, NY
• Providers in East Setauket, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.