Individual provider Active NPI

Stacey Sand, M.S., CCC-SLP

  • Speech-Language Pathologist
  • New York, NY
National Provider Identifier
1356653562
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
013603-1 Issued in NY
Practice address
562 W End Ave Apt 4C
Apt 4C
New York, NY 10024-2747
Phone
(212) 674-8566
NPI assigned
Jul 6, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 013603-1 NY Primary

Addresses

Primary practice location

562 W End Ave Apt 4C
Apt 4C
New York, NY 10024-2747

Mailing address

562 W End Ave Apt 4C
4C
New York, NY 10024-2747
Phone (212) 674-8566

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

LicenseStateTypeSpecialty
013603-1NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1356653562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "562 W END AVE APT 4C",
            "address_2": "4C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100242747",
            "telephone_number": "212-674-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "562 W END AVE APT 4C",
            "address_2": "APT 4C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100242747",
            "telephone_number": "212-674-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAND",
        "first_name": "STACEY",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-06",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "013603-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; 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.