Andrea Pannucci-Marvin, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS00267400 Issued in NJ

Practice address

10 Thomas St
New Providence, NJ 07974-2246

Phone

(908) 464-8225

Fax

(908) 464-2325

NPI assigned

Apr 7, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448841600000",
    "number": "1265675276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 THOMAS ST",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079742246",
            "telephone_number": "908-464-8225",
            "fax_number": "908-464-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 THOMAS ST",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079742246",
            "telephone_number": "908-464-8225",
            "fax_number": "908-464-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANNUCCI-MARVIN",
        "first_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-07",
        "last_updated": "2015-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "008369-1",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00267400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in New Providence, NJ
• Providers in New Providence, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; 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.