Active NPI
Kathy Polanco, MS CCC SLP
- Speech-Language Pathologist
- Middletown, NY
National Provider Identifier
1326323585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 005420-1
- Practice address
- 435 E Main St
Middletown, NY 10940-2515 - Phone
- (845) 326-1727
- NPI assigned
- Oct 19, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 005420-1 | NY | Primary |
Addresses
Primary practice location
435 E Main St
Middletown, NY 10940-2515
Mailing address
19 Hawk Hills Cir
Otisville, NY 10963-2924
Phone (845) 386-3411
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
| License | State | Type | Specialty |
|---|---|---|---|
| 005420-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318982400000",
"number": "1326323585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 HAWK HILLS CIR",
"city": "OTISVILLE",
"state": "NY",
"postal_code": "109632924",
"telephone_number": "845-386-3411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "435 E MAIN ST",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109402515",
"telephone_number": "845-326-1727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLANCO",
"first_name": "KATHY",
"name_prefix": "Mrs.",
"credential": "MS CCC SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-19",
"last_updated": "2011-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "005420-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.