Active NPI
Jessica Bryan, M.S.
- Speech-Language Pathologist
- Queens, NY
National Provider Identifier
1184879512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 018727
- Practice address
- 39-09 214 TH Place
Queens, NY 11361 - Phone
- (718) 229-5757
- NPI assigned
- Nov 26, 2008
- Last updated
- Nov 26, 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 | 018727 | NY | Primary |
Addresses
Primary practice location
39-09 214 TH Place
Queens, NY 11361
Mailing address
451 Jefferson Ave. Apt 3L
Brooklyn, NY 11221
Phone (803) 493-6593
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018727 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227657600000",
"number": "1184879512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "451 JEFFERSON AVE. APT 3L",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11221",
"telephone_number": "803-493-6593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39-09 214 TH PLACE",
"city": "QUEENS",
"state": "NY",
"postal_code": "11361",
"telephone_number": "718-229-5757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYAN",
"first_name": "JESSICA",
"name_prefix": "Ms.",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-26",
"last_updated": "2008-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "018727",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Queens, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.