Cristina D Gordon, CCC - SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

029508 Issued in NY

Practice address

4 Fairchild SQ
Clifton Park, NY 12065-1254

Phone

(518) 664-5066

NPI assigned

Dec 27, 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

• Ms. Cristina Giacobbe Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Marion K. Salomon

  • Early Intervention Provider Agency
  • Plainview, NY
  • NPI 1770846677
  NPD (past)
• Rd#1 Werner Rd LTD

  • Developmentally Disabled Services Day Training Agency
  • Clifton Park, NY
  • NPI 1699166017
  NPD (past)

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

{
    "created_epoch": "1545868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1194297408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1337 BROOKVIEW STATION RD",
            "city": "CASTLETON",
            "state": "NY",
            "postal_code": "120333118",
            "telephone_number": "516-307-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 FAIRCHILD SQ",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120651254",
            "telephone_number": "518-664-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "CRISTINA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "CCC - SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-27",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "029508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRISTINA",
            "last_name": "GIACOBBE",
            "prefix": "MS.",
            "credential": "CCC - SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lindsey Anne Goodell, DPT
• Andrew Robert Goodemote, DDS, MS
• Christopher Goodemote
• Aimee E Gordon
• Charles Fox Gordon III, MD
• Lara Suzanne Gordon, PHD
• Dina Gottesman, D.O
• John Graham, D.C.
• M Gretchen Grant, MD
• Stephen A Grant, M.D.

• Speech-Language Pathologist in Clifton Park, NY
• Providers in Clifton Park, 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 Apr 14, 2021; 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.