Madeline Match, S.L.P.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

003930-1 Issued in NY

Practice address

1200 Montauk Hwy
Oakdale, NY 11769-1540

Phone

(631) 567-4901

NPI assigned

Dec 27, 2011

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

Other identifiers 1

Other names 1

• Mrs. Madeline Waller Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Eastern Suffolk Boces

  • Public Health or Welfare Agency
  • Patchogue, NY
  • NPI 1073890091
  NPD (past)
• Esboces

  • Public Health or Welfare Agency
  • Patchogue, NY
  • NPI 1093092025
  NPD (past)

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324944000000",
    "number": "1346519998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SUNRISE HWY",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721868",
            "telephone_number": "631-289-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MONTAUK HWY",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691540",
            "telephone_number": "631-567-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATCH",
        "first_name": "MADELINE",
        "name_prefix": "Mrs.",
        "credential": "S.L.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-27",
        "last_updated": "2011-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "003930-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER:  003930-1",
            "identifier": "5194560",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADELINE",
            "last_name": "WALLER",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Andrea Marie Mancuso, MS.SPED
• Christina Marie Mancuso, SERVICE COORDINATOR
• Stefany Marte, MSW
• Jeanette Frances Martino, LPN
• Nicole Massina
• Grace R Matos-Brennen, PT
• Kim Marie Maurer, R.N.
• Megan J McAlpine, M.A., CCC SLP TSHH
• Daniel Mathew McCarthy, RN
• Michelle Irene McHugh, MA TVI

• Speech-Language Pathologist in Oakdale, NY
• Providers in Oakdale, 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 Dec 27, 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.

Verify at the official NPI Registry.