Individual provider Active NPI

Susane Dardeir, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Staten Island, NY
National Provider Identifier
1366876252
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
023073-1 Issued in NY
Practice address
34 Ramsey LN
Staten Island, NY 10314-5195
Phone
(732) 895-7805
Fax
(718) 494-4969
NPI assigned
Aug 27, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

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 023073-1 NY Primary

Addresses

Primary practice location

34 Ramsey LN
Staten Island, NY 10314-5195

Mailing address

34 Ramsey LN
Staten Island, NY 10314-5195
Phone (732) 895-7805

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 Arts

State licenses

LicenseStateTypeSpecialty
023073-1NYMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1366876252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 RAMSEY LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145195",
            "telephone_number": "732-895-7805",
            "fax_number": "718-494-4969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 RAMSEY LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145195",
            "telephone_number": "732-895-7805",
            "fax_number": "718-494-4969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARDEIR",
        "first_name": "SUSANE",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-27",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "023073-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; 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.