Individual provider Active NPI

Alexandra Brown, CCC-SLP

  • Speech-Language Pathologist
  • East Syracuse, NY
National Provider Identifier
1225578610
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
58026505 Issued in NY
Practice address
101 Spartan Way
East Syracuse, NY 13057-6001
Phone
(315) 434-3050
NPI assigned
Mar 3, 2017
Last updated
Oct 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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 58026505 NY Primary

Addresses

Primary practice location

101 Spartan Way
East Syracuse, NY 13057-6001

Mailing address

232 Coleridge Ave
Syracuse, NY 13204-2605
Phone (315) 212-0774

Other practice location 1

301 Prospect Ave
PM&R Dept
Syracuse, NY 13203-1807
Phone (315) 726-7072

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

LicenseStateTypeSpecialty
58026505NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1488499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1225578610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 COLERIDGE AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042605",
            "telephone_number": "315-212-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SPARTAN WAY",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130576001",
            "telephone_number": "315-434-3050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Prospect Ave",
            "address_2": "PM&R Dept",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132031807",
            "country_code": "US",
            "telephone_number": "315-726-7072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ALEXANDRA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-03",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "58026505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; 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.