Individual provider Active NPI

Eleanor Fichtelman, T.S.S.L.D.

  • Speech-Language Pathologist
  • Lido Beach, NY
National Provider Identifier
1184926784
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
928606 Issued in NY
Practice address
420 Lido Blvd
Lido Beach, NY 11561-5118
Phone
(516) 298-9697
NPI assigned
Dec 2, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2010

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 928606 NY Primary

Addresses

Primary practice location

420 Lido Blvd
Lido Beach, NY 11561-5118

Mailing address

420 Lido Blvd
Lido Beach, NY 11561-5118
Phone (516) 298-9697

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
928606NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291248000000",
    "number": "1184926784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 LIDO BLVD",
            "city": "LIDO BEACH",
            "state": "NY",
            "postal_code": "115615118",
            "telephone_number": "516-298-9697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 LIDO BLVD",
            "city": "LIDO BEACH",
            "state": "NY",
            "postal_code": "115615118",
            "telephone_number": "516-298-9697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FICHTELMAN",
        "first_name": "ELEANOR",
        "name_prefix": "Ms.",
        "credential": "T.S.S.L.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-02",
        "last_updated": "2010-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "928606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lido Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.