Active NPI
Ahuva Goldburd, SLP
- Speech-Language Pathologist
- Lakewood, NJ
National Provider Identifier
1215456355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 41YS00645200
- Practice address
- 95 Canary Dr
Lakewood, NJ 08701-5453 - Phone
- (917) 903-0667
- NPI assigned
- Sep 9, 2017
- 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 | 41YS00645200 | NJ | Primary |
Addresses
Primary practice location
95 Canary Dr
Lakewood, NJ 08701-5453
Mailing address
95 Canary Dr
Lakewood, NJ 08701-5453
Phone (917) 903-0667
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41YS00645200 | Other | NJ | NJ STATE LICENSE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1215456355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 CANARY DR",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087015453",
"telephone_number": "917-903-0667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 CANARY DR",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087015453",
"telephone_number": "917-903-0667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBURD",
"first_name": "AHUVA",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-09",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NJ",
"license": "41YS00645200",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NJ STATE LICENSE",
"identifier": "41YS00645200",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.