Daniella Nicole Siracusa

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

030130 Issued in NY

Practice address

40 Allen St
Brockport, NY 14420-2228

Phone

(585) 637-5303

NPI assigned

Dec 31, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Western New York Speech-Language Pathology, OT, and PT Consultants

  • Early Intervention Provider Agency
  • Victor, NY
  • NPI 1386812550

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1577750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1407495070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 STELLA LN",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "145599798",
            "telephone_number": "585-317-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 ALLEN ST",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144202228",
            "telephone_number": "585-637-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRACUSA",
        "first_name": "DANIELLA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-31",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "030130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew J Siergiej
• Sigillo Chiropractic PC
• Christopher J Sigillo, DC
• Peter J. Simone, RPA-C
• Melissa Siple
• Small to Tall Dentistry and Orthodontics Brockport
• Jolene Smeltzer
• Charlene M Smith, DNSC MSED WHNP BC
• Christina Smith, RDH
• David F Smith, M.D.

• Speech-Language Pathologist in Brockport, NY
• Providers in Brockport, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.