Organization Active NPI

Li Professional Speech PLLC

  • Speech-Language Pathologist
  • West Babylon, NY
National Provider Identifier
1396573721
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
LI PROFESSIONAL SPEECH PLLC
Practice address
1436 13TH St
West Babylon, NY 11704-3224
Phone
(631) 905-9983
NPI assigned
Jul 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Matthew Demattia, MS, CCC-SLPNPI 1376169201
Title
Co-Owner
Phone
(631) 905-9983

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

1436 13TH St
West Babylon, NY 11704-3224

Mailing address

1436 13TH St
West Babylon, NY 11704-3224
Phone (631) 905-9983

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1396573721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 13TH ST",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117043224",
            "telephone_number": "631-905-9983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 13TH ST",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117043224",
            "telephone_number": "631-905-9983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LI PROFESSIONAL SPEECH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A",
        "authorized_official_last_name": "DEMATTIA",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "631-905-9983",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Babylon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.