Active NPI
Paul A. Imbert, MA, CCC-SLP
- Speech-Language Pathologist
- Kenmore, NY
National Provider Identifier
1376906362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 009737-1
- Practice address
- 86 Chatsworth Ave
Apartment 4
Kenmore, NY 14217-1446 - Phone
- (716) 877-1230
- NPI assigned
- Mar 29, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 009737-1 | NY | Primary |
Addresses
Primary practice location
86 Chatsworth Ave
Apartment 4
Kenmore, NY 14217-1446
Mailing address
86 Chatsworth Ave
Apartment 4
Kenmore, NY 14217-1446
Phone (716) 877-1230
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
| License | State | Type | Specialty |
|---|---|---|---|
| 009737-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459209600000",
"number": "1376906362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "86 CHATSWORTH AVE",
"address_2": "APARTMENT 4",
"city": "KENMORE",
"state": "NY",
"postal_code": "142171446",
"telephone_number": "716-877-1230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "86 CHATSWORTH AVE",
"address_2": "APARTMENT 4",
"city": "KENMORE",
"state": "NY",
"postal_code": "142171446",
"telephone_number": "716-877-1230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IMBERT",
"first_name": "PAUL",
"middle_name": "A.",
"name_prefix": "Mr.",
"credential": "MA, CCC-SLP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-03-29",
"last_updated": "2016-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "009737-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenmore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.