Individual provider Active NPI

Jorge Nelson Gonzalez, SLP

  • Speech-Language Pathologist
  • New York, NY
National Provider Identifier
1265687610
Registry record updated Nov 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
010613 Issued in NY
Practice address
560 W 43Rd St Apt 18H
New York, NY 10036-4313
Phone
(191) 786-0374
Fax
(212) 216-9157
NPI assigned
Nov 26, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2008

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 010613 NY Primary

Addresses

Primary practice location

560 W 43Rd St Apt 18H
New York, NY 10036-4313

Mailing address

560 W 43Rd St Apt 18H
New York, NY 10036-4313
Phone (191) 786-0374

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

NPI Registry JSON

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

{
    "created_epoch": "1227657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227657600000",
    "number": "1265687610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 W 43RD ST APT 18H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100364313",
            "telephone_number": "191-786-0374",
            "fax_number": "212-216-9157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 W 43RD ST APT 18H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100364313",
            "telephone_number": "191-786-0374",
            "fax_number": "212-216-9157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JORGE",
        "middle_name": "NELSON",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-26",
        "last_updated": "2008-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "010613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2008; 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.