Individual provider Active NPI

Maryann Abbondandolo, SLP

  • Speech-Language Pathologist
  • Glen Cove, NY
National Provider Identifier
1255733838
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
017551-1 Issued in NY
Practice address
49 Southridge Dr
Glen Cove, NY 11542-4029
Phone
(516) 376-7399
NPI assigned
Sep 25, 2014
Last updated
Sep 25, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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 017551-1 NY Primary

Addresses

Primary practice location

49 Southridge Dr
Glen Cove, NY 11542-4029

Mailing address

49 Southridge Dr
Glen Cove, NY 11542-4029
Phone (516) 376-7399

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
017551-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411603200000",
    "number": "1255733838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 SOUTHRIDGE DR",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115424029",
            "telephone_number": "516-376-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 SOUTHRIDGE DR",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115424029",
            "telephone_number": "516-376-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBONDANDOLO",
        "first_name": "MARYANN",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-25",
        "last_updated": "2014-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "017551-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; 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.