Jennifer Ann Cavallo

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

011641-1 Issued in NY

Practice address

15 Seward LN
Stony Brook, NY 11790

Phone

(631) 689-2898

NPI assigned

Dec 3, 2008

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 names 1

• Jennifer Baldi Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1255576476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SEWARD LANE",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11790",
            "telephone_number": "631-689-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SEWARD LN",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11790",
            "telephone_number": "631-689-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVALLO",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-03",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "011641-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BALDI",
            "credential": "MA CCC/SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Frederick E Caston, M.D.
• Derek Castro II
• Rosa Cataldo, DO
• Tara Marie Catanzano, MD
• Marianna Catege, DO
• Mary F. Cavanagh, M.D.,M.P.H.
• Cda Medical, PLLC
• Cedar Massage Therapy PC
• Mahmut Yasar Celiker, M.D.
• Mishelle Stefany Centeno Gavica

• Speech-Language Pathologist in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; 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.