Individual provider Active NPI

Nathalia Andrea Fonseca, SLPD CCCSLP, TSSLDBE

  • Speech-Language Pathologist
  • Kew Gardens, NY
National Provider Identifier
1356737068
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
8015 Lefferts Blvd # 2F
Kew Gardens, NY 11415-1738
Phone
(917) 774-3847
Fax
(347) 778-0726
NPI assigned
Apr 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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 Primary

Addresses

Primary practice location

8015 Lefferts Blvd # 2F
Kew Gardens, NY 11415-1738

Mailing address

8015 Lefferts Blvd # 2F
Kew Gardens, NY 11415-1738
Phone (718) 880-2468

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
025660NYMDClinical Neuropsychologist

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

NPI Registry JSON

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1356737068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8015 LEFFERTS BLVD # 2F",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151738",
            "telephone_number": "718-880-2468",
            "fax_number": "347-778-0726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8015 LEFFERTS BLVD # 2F",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151738",
            "telephone_number": "917-774-3847",
            "fax_number": "347-778-0726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONSECA",
        "first_name": "NATHALIA",
        "middle_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "SLPD CCCSLP, TSSLDBE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-09",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kew Gardens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; 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.