Individual provider Active NPI

Euna Paik, CCC-SLP

  • Speech-Language Pathologist
  • Tenafly, NJ
National Provider Identifier
1306215041
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS00795200 Issued in NJ
Practice address
22 Porter Ave
Tenafly, NJ 07670-2432
Phone
(865) 816-4102
NPI assigned
Sep 23, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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 41YS00795200 NJ Primary

Addresses

Primary practice location

22 Porter Ave
Tenafly, NJ 07670-2432

Mailing address

22 Porter Ave
Tenafly, NJ 07670-2432
Phone (865) 816-4102

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
41YS00795200NJMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Good News Hearing and Communication Center CurrentSince May 21, 2018 Accepting new patients

Locations

375 Sylvan Ave
Ste 6
Englewood Cliffs, NJ 07632
Phone (201) 912-4055

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1306215041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 PORTER AVE",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076702432",
            "telephone_number": "865-816-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 PORTER AVE",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076702432",
            "telephone_number": "865-816-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAIK",
        "first_name": "EUNA",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00795200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tenafly, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.