Individual provider Active NPI

Grace Adriana Frutos Paucar

  • Speech-Language Pathologist
  • Long Island City, NY
National Provider Identifier
1437647047
Registry record updated Apr 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
3100 47TH Ave # 2120D
Long Island City, NY 11101-3013
Phone
(718) 593-4121
NPI assigned
Apr 29, 2018
Last updated
Apr 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2018

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 NU Primary

Addresses

Primary practice location

3100 47TH Ave # 2120D
Long Island City, NY 11101-3013

Mailing address

4148 40TH St Apt D7
Sunnyside, NY 11104-3725
Phone (347) 330-1587

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

NPI Registry JSON

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

{
    "created_epoch": "1524960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524960000000",
    "number": "1437647047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4148 40TH ST APT D7",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111043725",
            "telephone_number": "347-330-1587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 47TH AVE # 2120D",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111013013",
            "telephone_number": "718-593-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUTOS PAUCAR",
        "first_name": "GRACE",
        "middle_name": "ADRIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-29",
        "last_updated": "2018-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2018; 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.