Edjae Villamor Siriban, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

1901 1St Ave
New York, NY 10029-7494

Phone

(212) 423-6262

NPI assigned

Jun 17, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Physician Affiliate Group of New York PC

  • Registered Dietitian
  • New York, NY
  • NPI 1013375526
  Medicare reassignment NPD

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

{
    "created_epoch": "1655424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1316678782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 ANDERSON AVE APT 23",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070241732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100297494",
            "telephone_number": "212-423-6262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Central Ave Apt 5B",
            "address_purpose": "LOCATION",
            "city": "Fort Lee",
            "state": "NJ",
            "postal_code": "070247311",
            "country_code": "US",
            "telephone_number": "973-534-8796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIRIBAN",
        "first_name": "EDJAE",
        "middle_name": "VILLAMOR",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-17",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jo Anne Sirey, PHD
• Siri R Smith DC PC
• Yashira G Siri, BA
• Ongarj Siriamonthep, RPH
• Robert Sirianni Jr., M.S., L.AC.
• Siringo Optometry Associates, PLLC
• Ethel Silverman Siris, M.D.
• Roshana Meira Sirkin, PA-C
• Daniel Joseph Sirna
• David Alan Sirois, DMD,PHD

• Speech-Language Pathologist in New York, NY
• Providers in New York, 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 Apr 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.