Active NPI
Shlomo Aharon Holtzberg, M.S. CCC/SLP
- Speech-Language Pathologist
- Monsey, NY
National Provider Identifier
1194960609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1212829
- Practice address
- 23 Voyager CT
Monsey, NY 10952-1652 - Phone
- (845) 709-6307
- NPI assigned
- Dec 12, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 019020-1 | NY | |
| Speech-Language Pathologist | 235Z00000X | 1212829 | NY | Primary |
Addresses
Primary practice location
23 Voyager CT
Monsey, NY 10952-1652
Mailing address
23 Voyager CT
Monsey, NY 10952-1652
Phone (845) 709-6307
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1212829 | NY | MD | Speech-Language Pathologist |
| 019020-1 | NY | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277251200000",
"number": "1194960609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 VOYAGER CT",
"city": "MONSEY",
"state": "NY",
"postal_code": "109521652",
"telephone_number": "845-709-6307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 VOYAGER CT",
"city": "MONSEY",
"state": "NY",
"postal_code": "109521652",
"telephone_number": "845-709-6307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLTZBERG",
"first_name": "SHLOMO",
"middle_name": "AHARON",
"name_prefix": "Mr.",
"credential": "M.S. CCC/SLP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-12",
"last_updated": "2010-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "019020-1",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "1212829",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Monsey, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.