Individual provider Active NPI

Susan L Crocco, SLP SPEECH LANGUAGE

  • Speech-Language Pathologist
  • Somers, NY
National Provider Identifier
1376730630
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
0066091 Issued in NY
Practice address
52 Stone House Rd
Somers, NY 10589-2510
Phone
(914) 276-3775
Fax
(914) 276-3137
NPI assigned
Oct 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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 0066091 NY Primary

Addresses

Primary practice location

52 Stone House Rd
Somers, NY 10589-2510

Mailing address

52 Stone House Rd
Somers, NY 10589
Phone (914) 276-3775

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

State licenses

LicenseStateTypeSpecialty
0066091NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1376730630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 STONE HOUSE RD",
            "city": "SOMERS",
            "state": "NY",
            "postal_code": "10589",
            "telephone_number": "914-276-3775",
            "fax_number": "914-276-3137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 STONE HOUSE RD",
            "city": "SOMERS",
            "state": "NY",
            "postal_code": "105892510",
            "telephone_number": "914-276-3775",
            "fax_number": "914-276-3137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCCO",
        "first_name": "SUSAN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "SLP SPEECH LANGUAGE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "0066091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.