Michelle Pruner

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

027445 Issued in NY

Practice address

445 Beach 135TH St
Belle Harbor, NY 11694-1307

Phone

(718) 318-5201

NPI assigned

Mar 28, 2018

Last updated

Oct 29, 2021By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1275038515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4359 169TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 BEACH 135TH ST",
            "city": "BELLE HARBOR",
            "state": "NY",
            "postal_code": "116941307",
            "telephone_number": "718-318-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUNER",
        "first_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-28",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "027445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE LICENSE",
            "identifier": "027445",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Belle Harbor, NY
• Providers in Belle Harbor, 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 Oct 29, 2021; 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.