Caroline Kay Vivacqua

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

2550 88TH St
East Elmhurst, NY 11369-1010

Phone

(718) 397-7851

NPI assigned

May 7, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ms. Caroline Kay Pina Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1194135467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 TARRY LN",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117564026",
            "telephone_number": "646-284-2602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 88TH ST",
            "city": "EAST ELMHURST",
            "state": "NY",
            "postal_code": "113691010",
            "telephone_number": "718-397-7851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVACQUA",
        "first_name": "CAROLINE",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-07",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "025013",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04307851",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINE",
            "last_name": "PINA",
            "middle_name": "KAY",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Silvia Verga
• Jenny Verghese
• Lauren Nicole Vicente, LMSW
• Carla B Vicuna, BCBA, LBA
• Visiting Nurse Service of New York Home Care- Early Intervention
• Walgreen Co
• Walgreen Eastern Co Inc
• Debora Weaver Guzman
• Welllife Network Inc
• Wellness Transit LLC

• Speech-Language Pathologist in East Elmhurst, NY
• Providers in East Elmhurst, 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 Nov 13, 2019; 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.