Individual provider Active NPI

Jessica Sarah Ambalo

  • Speech-Language Pathologist
  • Bronx, NY
National Provider Identifier
1386266294
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
2447 Eastchester Rd
Bronx, NY 10469-5915
Phone
(347) 971-8184
NPI assigned
May 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2020

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

2447 Eastchester Rd
Bronx, NY 10469-5915

Mailing address

11 William Penn Rd
Great Neck, NY 11023-1043
Phone (347) 971-8184

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

NPI Registry JSON

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1386266294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 WILLIAM PENN RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110231043",
            "telephone_number": "347-971-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2447 EASTCHESTER RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695915",
            "telephone_number": "347-971-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBALO",
        "first_name": "JESSICA",
        "middle_name": "SARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-13",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; 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.