Active NPI
Mary Randall
- Speech-Language Pathologist
- Mamaroneck, NY
National Provider Identifier
1205449147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 028613-1
- Practice address
- 1000 W Boston Post Rd
Mamaroneck, NY 10543-3328 - Phone
- (914) 220-3060
- NPI assigned
- Aug 30, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 028613-1 | NY | Primary |
Addresses
Primary practice location
1000 W Boston Post Rd
Mamaroneck, NY 10543-3328
Mailing address
PO Box 5312
Brookfield, CT 06804-5312
Phone (860) 488-4479
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 028613-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598745600000",
"number": "1205449147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5312",
"city": "BROOKFIELD",
"state": "CT",
"postal_code": "068045312",
"telephone_number": "860-488-4479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 W BOSTON POST RD",
"city": "MAMARONECK",
"state": "NY",
"postal_code": "105433328",
"telephone_number": "914-220-3060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDALL",
"first_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-30",
"last_updated": "2020-08-30",
"certification_date": "2020-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "028613-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mamaroneck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.