Kristine Ann Faragasso, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

010590-1 Issued in NY

Practice address

745 Sycamore Ave
Bohemia, NY 11716-3514

Phone

(631) 244-2261

NPI assigned

Sep 15, 2010

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Connetquot CSD of Islip

  • Local Education Agency (LEA)
  • Bohemia, NY
  • NPI 1255487740
  NPD (past)

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

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1346558103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 SYCAMORE AVE",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117163514",
            "telephone_number": "631-244-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 SYCAMORE AVE",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117163514",
            "telephone_number": "631-244-2261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Connetquot CSD of Islip",
            "address_2": "780 Ocean Ave.",
            "address_purpose": "LOCATION",
            "city": "Bohemia",
            "state": "NY",
            "postal_code": "11716",
            "country_code": "US",
            "telephone_number": "631-664-2991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARAGASSO",
        "first_name": "KRISTINE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "010590-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Bohemia, NY
• Providers in Bohemia, 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 13, 2018; 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.