T.a.G. the Academic Gym LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

T.A.G. THE ACADEMIC GYM LLC

Practice address

51 Muktanada Marg
Walden, NY 12586-2352

Phone

(917) 861-5243

Fax

(845) 787-0198

NPI assigned

Oct 7, 2025

Last updated

Oct 7, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brian Cyril Vieira

Title

President

Phone

(833) 433-7323

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1759795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759795200000",
    "number": "1306711734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 CONTINENTAL DR",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125535609",
            "telephone_number": "917-861-5243",
            "fax_number": "917-861-5243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 MUKTANADA MARG",
            "city": "WALDEN",
            "state": "NY",
            "postal_code": "125862352",
            "telephone_number": "917-861-5243",
            "fax_number": "845-787-0198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T.A.G. THE ACADEMIC GYM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-07",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A",
        "authorized_official_last_name": "VIEIRA",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "CYRIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "833-433-7323"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.