Active NPI
Kristen Mincin, MA, CCC-SLP, TSSLD
- Speech-Language Pathologist
- Bronx, NY
National Provider Identifier
1396464699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 032183
- Practice address
- 500 E Fordham Rd
Bronx, NY 10458-5048 - Phone
- (718) 563-7139
- NPI assigned
- Aug 22, 2022
- Sex
- Female
- 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 | 032183 | NY | Primary |
Addresses
Primary practice location
500 E Fordham Rd
Bronx, NY 10458-5048
Mailing address
2857 Lafayette Ave
Bronx, NY 10465-2220
Phone (917) 583-8643
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 |
|---|---|---|---|
| 032183 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661126400000",
"number": "1396464699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2857 LAFAYETTE AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104652220",
"telephone_number": "917-583-8643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 E FORDHAM RD",
"city": "BRONX",
"state": "NY",
"postal_code": "104585048",
"telephone_number": "718-563-7139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINCIN",
"first_name": "KRISTEN",
"credential": "MA, CCC-SLP, TSSLD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-22",
"last_updated": "2022-08-22",
"certification_date": "2022-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "032183",
"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 Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.