Genesis Healthcare

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

021023 Issued in NY

Legal business name

GENESIS HEALTHCARE

Practice address

161 Madison Ave
2ND Floor
New York, NY 10016-5421

Phone

(212) 683-8905

NPI assigned

Jul 1, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Alicia Wang, MS-CCC/SLP

Title

Speeh Language Pathologist

Phone

(617) 663-7023

Specialties & licenses 2

Addresses

Other names 1

• Funtional Life Achievement Inc. Other name

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323129600000",
    "number": "1295022978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 E 17TH ST APT 5C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 MADISON AVE",
            "address_2": "2ND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165421",
            "telephone_number": "212-683-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-01",
        "last_updated": "2011-12-06",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "SPEEH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "617-663-7023",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS-CCC/SLP"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "021023",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "7941",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Funtional Life Achievement Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Generation Next Fertility PLLC
• Philippe Genereux, M.D.
• Charles Generotti, MD
• Nicholas Genes, MD, PHD
• Genesis Foot and Ankle Center Inc
• Genesis Medical Diagnostics, P.C.
• Genesis Wellness Group LLC
• Andrew Geneslaw, MD
• Lyne Geneste, D.O.
• Rachel Geneste, REGISTERED DIETITIAN

• Early Intervention Provider Agency in New York, NY
• Providers in New York, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.