Individual provider Active NPI

Mildred Viera Ceron, MS- CCC/SLP

  • Speech-Language Pathologist
  • New York, NY
National Provider Identifier
1295069789
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
005636-1 Issued in NY
Practice address
554 Fort Washington Ave
New York, NY 10033-2003
Phone
(212) 740-5157
NPI assigned
Sep 30, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

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 005636-1 NY Primary

Addresses

Primary practice location

554 Fort Washington Ave
New York, NY 10033-2003

Mailing address

15 Meadowbrook Rd
Irvington, NY 10533-1203
Phone (914) 591-6785

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
005636-1NYMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254268800000",
    "number": "1295069789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MEADOWBROOK RD",
            "city": "IRVINGTON",
            "state": "NY",
            "postal_code": "105331203",
            "telephone_number": "914-591-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100332003",
            "telephone_number": "212-740-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERON",
        "first_name": "MILDRED",
        "middle_name": "VIERA",
        "name_prefix": "Mrs.",
        "credential": "MS- CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-30",
        "last_updated": "2009-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "005636-1",
            "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 Sep 30, 2009; 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.