Individual provider Active NPI

Mary Jo Montijo, SLP-CCC, MS, TSHH

  • Speech-Language Pathologist
  • Brooklyn, NY
National Provider Identifier
1205089760
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
016636-1 Issued in NY
Practice address
7214 Fort Hamilton Pkwy
3B
Brooklyn, NY 11228-1906
Phone
(347) 394-4510
Fax
(347) 394-4510
NPI assigned
Oct 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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 016636-1 NY Primary

Addresses

Primary practice location

7214 Fort Hamilton Pkwy
3B
Brooklyn, NY 11228-1906

Mailing address

7214 Fort Hamilton Pkwy
3B
Brooklyn, NY 11228-1906
Phone (347) 394-4510

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 Science

State licenses

LicenseStateTypeSpecialty
016636-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1205089760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7214 FORT HAMILTON PKWY",
            "address_2": "3B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112281906",
            "telephone_number": "347-394-4510",
            "fax_number": "347-394-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7214 FORT HAMILTON PKWY",
            "address_2": "3B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112281906",
            "telephone_number": "347-394-4510",
            "fax_number": "347-394-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTIJO",
        "first_name": "MARY JO",
        "name_prefix": "Mrs.",
        "credential": "SLP-CCC, MS, TSHH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "016636-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.