Individual provider Active NPI

Danita A Susi

  • Speech-Language Pathologist
  • Staten Island, NY
National Provider Identifier
1245526425
Registry record updated Jun 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
012588-1 Issued in NY
Practice address
921 W Fingerboard Rd
Staten Island, NY 10304-4453
Phone
(917) 279-6308
NPI assigned
Jun 25, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2011

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 012588-1 NY Primary

Addresses

Primary practice location

921 W Fingerboard Rd
Staten Island, NY 10304-4453

Mailing address

921 W Fingerboard Rd
Staten Island, NY 10304-4453

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
012588-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1308960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308960000000",
    "number": "1245526425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 W FINGERBOARD RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 W FINGERBOARD RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044453",
            "telephone_number": "917-279-6308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSI",
        "first_name": "DANITA",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-25",
        "last_updated": "2011-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "012588-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2011; 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.