Active NPI
Alyssa Bollag
- Speech-Language Pathologist
- Bronx, NY
National Provider Identifier
1396145546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 023452-1
- Practice address
- 1925 Eastchester Rd
Apt 6E
Bronx, NY 10461-2103 - Phone
- (917) 567-5683
- NPI assigned
- Aug 25, 2014
- Sex
- Female
- Sole proprietor
- No
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 | 023452-1 | NY | Primary |
Addresses
Primary practice location
1925 Eastchester Rd
Apt 6E
Bronx, NY 10461-2103
Mailing address
1925 Eastchester Rd
Apt 6E
Bronx, NY 10461-2103
Phone (917) 567-5683
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 023452-1 | Other | NY | LICENSE# |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408924800000",
"number": "1396145546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1925 EASTCHESTER RD",
"address_2": "APT 6E",
"city": "BRONX",
"state": "NY",
"postal_code": "104612103",
"telephone_number": "917-567-5683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1925 EASTCHESTER RD",
"address_2": "APT 6E",
"city": "BRONX",
"state": "NY",
"postal_code": "104612103",
"telephone_number": "917-567-5683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLLAG",
"first_name": "ALYSSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-25",
"last_updated": "2014-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "023452-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE#",
"identifier": "023452-1",
"state": "NY"
}
],
"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 Aug 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.