Active NPI
Nicole D'Amico-Stonbraker
- Speech-Language Pathologist
- Williston Park, NY
National Provider Identifier
1255638201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 020730
- Practice address
- 436 Willis Ave
3Rd Floor
Williston Park, NY 11596-2298 - Phone
- (516) 741-0729
- NPI assigned
- Feb 26, 2011
- Last updated
- Aug 30, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 020730 | NY | Primary |
Addresses
Primary practice location
436 Willis Ave
3Rd Floor
Williston Park, NY 11596-2298
Mailing address
43 Island Trail
Mt. Sinai, NY 11766
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
| License | State | Type | Specialty |
|---|---|---|---|
| 020730 | NY | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids Learning Loft ABA Services, PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Behavior Analyst
- Williston Park, NY
- NPI 1962758946
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377820800000",
"number": "1255638201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 ISLAND TRAIL",
"city": "MT. SINAI",
"state": "NY",
"postal_code": "11766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "436 WILLIS AVE",
"address_2": "3RD FLOOR",
"city": "WILLISTON PARK",
"state": "NY",
"postal_code": "115962298",
"telephone_number": "516-741-0729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "D'AMICO-STONBRAKER",
"first_name": "NICOLE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-26",
"last_updated": "2013-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "020730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williston Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.