Individual provider Active NPI

Rosa Enriqueta Mannozzi, SLP

  • Speech-Language Pathologist
  • Pelham, NY
National Provider Identifier
1417102195
Registry record updated Jul 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
0177821 Issued in NY
Practice address
622 Pelhamdale Ave
Apt 48
Pelham, NY 10803-2809
Phone
(631) 805-8564
NPI assigned
Nov 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2010

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 0177821 NY Primary

Addresses

Primary practice location

622 Pelhamdale Ave
Apt 48
Pelham, NY 10803-2809

Mailing address

622 Pelhamdale Ave
Apt 48
Pelham, NY 10803-2809
Phone (631) 805-8564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161027001357 NY Practitioner - Qualified Speech Language Pathologist 8820376718 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
017782NYMDPsychologist
0177821NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Union Community Health Center, Inc. CurrentSince Aug 31, 2016 Accepting new patients

Locations

260 E 188th St
#5
Bronx, NY 10458

260 E 188th St
Bronx, NY 10458
Phone (718) 618-8236

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1227398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280448000000",
    "number": "1417102195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 PELHAMDALE AVE",
            "address_2": "APT 48",
            "city": "PELHAM",
            "state": "NY",
            "postal_code": "108032809",
            "telephone_number": "631-805-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 PELHAMDALE AVE",
            "address_2": "APT 48",
            "city": "PELHAM",
            "state": "NY",
            "postal_code": "108032809",
            "telephone_number": "631-805-8564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNOZZI",
        "first_name": "ROSA",
        "middle_name": "ENRIQUETA",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-23",
        "last_updated": "2010-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "0177821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pelham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.