Kelly Peredo

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

83 Sunny Rd
Saint James, NY 11780-3019

Phone

(631) 275-4409

NPI assigned

Sep 1, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1504224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1205354958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 MORICHES RD",
            "city": "SAINT JAMES",
            "state": "NY",
            "postal_code": "117801366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 SUNNY RD",
            "city": "SAINT JAMES",
            "state": "NY",
            "postal_code": "117803019",
            "telephone_number": "631-275-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREDO",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-01",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Diane Palma, DDS
• Christine Panettieri
• Andrew Parisi, LCSW
• Ellen Lori Pecchia, MS, LMHC
• Judith Ann Pedley, OT
• Jannine M Pergola, M.S, LMHC
• Marisa Anne Persichilli, P.T., D.P.T.
• Lisa A Phillips-Springer, M.S. CCC/LSP
• Marco Anthony Picariello, D.C.
• Darlene A. Pick, R.N.

• Speech-Language Pathologist in Saint James, NY
• Providers in Saint James, 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 Sep 30, 2024; 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.