Individual provider Active NPI

Jolene Ann Dombrosky, MA, CCC-SLP

  • Speech-Language Pathologist
  • Valley Stream, NY
National Provider Identifier
1194907824
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
0137773-1 Issued in NY
Practice address
9 Cameron LN
Valley Stream, NY 11581-1707
Phone
(516) 837-3626
NPI assigned
Dec 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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 0137773-1 NY Primary

Addresses

Primary practice location

9 Cameron LN
Valley Stream, NY 11581-1707

Mailing address

9 Cameron LN
Valley Stream, NY 11581-1707
Phone (516) 837-3626

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
0137773-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1194907824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CAMERON LN",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811707",
            "telephone_number": "516-837-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CAMERON LN",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811707",
            "telephone_number": "516-837-3626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMBROSKY",
        "first_name": "JOLENE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-05",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "0137773-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; 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.