Active NPI
Susana Elizabeth Avalos, SLP
- Speech-Language Pathologist
- Brooklyn, NY
National Provider Identifier
1184934093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 019283
- Practice address
- 630 Grand St
Apt 2
Brooklyn, NY 11211-4804 - Phone
- (212) 470-0911
- NPI assigned
- Oct 13, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | 019283 | NY | Primary |
Addresses
Primary practice location
630 Grand St
Apt 2
Brooklyn, NY 11211-4804
Mailing address
65-41 Saunders St
Apt 1E
Rego Park, Queens, NY 11374
Phone (226) 201-0608
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019283 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499817600000",
"number": "1184934093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65-41 SAUNDERS ST",
"address_2": "APT 1E",
"city": "REGO PARK, QUEENS",
"state": "NY",
"postal_code": "11374",
"telephone_number": "226-201-0608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 GRAND ST",
"address_2": "APT 2",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112114804",
"telephone_number": "212-470-0911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVALOS",
"first_name": "SUSANA",
"middle_name": "ELIZABETH",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-13",
"last_updated": "2017-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "019283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.