Individual provider Active NPI

Stacey Anne Marra, SLP, MS, CCC

  • Speech-Language Pathologist
  • Hawthorne, NY
National Provider Identifier
1245484575
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
005399 Issued in NY
Practice address
5 Bradhurst Ave
Hawthorne, NY 10532-2135
Phone
(914) 606-0087
NPI assigned
Nov 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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 005399 NY Primary

Addresses

Primary practice location

5 Bradhurst Ave
Hawthorne, NY 10532-2135

Mailing address

1 Greenlawn Rd
Cortlandt Manor, NY 10567
Phone (914) 606-0087

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

NPI Registry JSON

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

{
    "created_epoch": "1226534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1245484575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GREENLAWN RD",
            "city": "CORTLANDT MANOR",
            "state": "NY",
            "postal_code": "10567",
            "telephone_number": "914-606-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BRADHURST AVE",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322135",
            "telephone_number": "914-606-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRA",
        "first_name": "STACEY",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "SLP, MS, CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-13",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "005399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.