Active NPI
Sophia Park
- Speech-Language Pathologist
- Clifton Park, NY
National Provider Identifier
1396343828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 1 Abele Dr
Clifton Park, NY 12065-2951 - Phone
- (518) 371-1400
- NPI assigned
- Oct 16, 2020
- Last updated
- Oct 16, 2020
- 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 | NY | Primary |
Addresses
Primary practice location
1 Abele Dr
Clifton Park, NY 12065-2951
Mailing address
16 W Erie St
Albany, NY 12208-2404
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": "1602806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602806400000",
"number": "1396343828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 W ERIE ST",
"city": "ALBANY",
"state": "NY",
"postal_code": "122082404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 ABELE DR",
"city": "CLIFTON PARK",
"state": "NY",
"postal_code": "120652951",
"telephone_number": "518-371-1400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "SOPHIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-16",
"last_updated": "2020-10-16",
"certification_date": "2020-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clifton Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.