Isabella Rae Eccleston Busch

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

028942 Issued in NY

Practice address

51 School St
Lake Ronkonkoma, NY 11779-2298

Phone

(631) 471-1300

NPI assigned

Jul 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Isabella Rae Rodriguez Eccleston Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1194201848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 UNION BLVD",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117513207",
            "telephone_number": "631-383-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 SCHOOL ST",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117792298",
            "telephone_number": "631-471-1300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1560 Mayflower Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104615400",
            "country_code": "US",
            "telephone_number": "718-948-1900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSCH",
        "first_name": "ISABELLA",
        "middle_name": "RAE ECCLESTON",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-16",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "028942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ISABELLA",
            "last_name": "ECCLESTON",
            "middle_name": "RAE RODRIGUEZ",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Edjeanine Boucicault, LPN
• Ryan Joseph Branigan, MA-SLP
• Tracy K Brooks, O.D.
• Corryn Taylor Brown
• Kristen Iris Bunze
• Dana G. Bush, PH.D.
• Shane Bush, PH.D.
• Andrew William Caradona, RPH
• Nicolette Carmine
• Veronica Carrier, LMSW

• Speech-Language Pathologist in Lake Ronkonkoma, NY
• Providers in Lake Ronkonkoma, 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 Aug 23, 2022; 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.