Edna K. Payne, M.A.,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS00144300 Issued in NJ

Practice address

117 Kinderkamack Rd Ste 107
River Edge, NJ 07661-1916

Phone

(201) 487-1497

Fax

(201) 816-3117

NPI assigned

Jun 12, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245434430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 HOWLAND AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076313229",
            "telephone_number": "201-569-3454",
            "fax_number": "201-816-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 KINDERKAMACK RD STE 107",
            "city": "RIVER EDGE",
            "state": "NJ",
            "postal_code": "076611916",
            "telephone_number": "201-487-1497",
            "fax_number": "201-816-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "EDNA",
        "middle_name": "K.",
        "name_prefix": "Mrs.",
        "credential": "M.A.,CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00144300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH PATHOLOGIST",
            "identifier": "41YS00144300",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angel Park, LCAT
• Hyunsoo Park, L.AC
• James Park, PT, DPT
• Shivani Kamlesh Patel
• Jency Paul, DMD
• Mireya Pazmino, APN
• Peoplefirst Home Care
• Jeny Perez-Puerta, RN
• Maria Nunzia Petruzzelli, WHNP-BC
• Vasyl Pidkaminetskiy, M.D.

• Speech-Language Pathologist in River Edge, NJ
• Providers in River Edge, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.