Individual provider Active NPI

Robin Zicherman

  • Speech-Language Pathologist
  • Lakewood, NJ
National Provider Identifier
1396413563
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS01036700 Issued in NJ
Practice address
40A Garden of Eden Dr
Lakewood, NJ 08701-4168
Phone
(917) 863-0008
NPI assigned
Sep 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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 41YS01036700 NJ Primary

Addresses

Primary practice location

40A Garden of Eden Dr
Lakewood, NJ 08701-4168

Mailing address

40A Garden of Eden Dr
Lakewood, NJ 08701-4168

Other practice location 1

140 Regent Dr
Lakewood, NJ 08701-3026
Phone (917) 863-0008

Other identifiers 1

IdentifierTypeStateIssuer
41YS01036700OtherNJNJ 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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
41YS01036700NJMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1396413563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40A GARDEN OF EDEN DR",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40A GARDEN OF EDEN DR",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014168",
            "telephone_number": "917-863-0008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Regent Dr",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "NJ",
            "postal_code": "087013026",
            "country_code": "US",
            "telephone_number": "917-863-0008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZICHERMAN",
        "first_name": "ROBIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS01036700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ LICENSE",
            "identifier": "41YS01036700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.