Individual provider Active NPI

Lauren Ayn Scalise, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Middle Village, NY
National Provider Identifier
1205973468
Registry record updated Nov 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
012788 Issued in NY
Practice address
6430 77TH PL
3Rd Floor
Middle Village, NY 11379-2212
Phone
(917) 690-3874
Fax
(718) 416-3171
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 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 012788 NY Primary

Addresses

Primary practice location

6430 77TH PL
3Rd Floor
Middle Village, NY 11379-2212

Mailing address

6430 77TH PL
3Rd Floor
Middle Village, NY 11379-2212
Phone (917) 690-3874

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
012788NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226361600000",
    "number": "1205973468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6430 77TH PL",
            "address_2": "3RD FLOOR",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113792212",
            "telephone_number": "917-690-3874",
            "fax_number": "718-416-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6430 77TH PL",
            "address_2": "3RD FLOOR",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113792212",
            "telephone_number": "917-690-3874",
            "fax_number": "718-416-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCALISE",
        "first_name": "LAUREN",
        "middle_name": "AYN",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2008-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "012788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.