Individual provider Active NPI

Michael Richard Connelly, TSHH

  • Speech-Language Assistant
  • Brooklyn, NY
National Provider Identifier
1447408976
Registry record updated Sep 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
763469 Issued in NY
Practice address
1863 Stuart St
Brooklyn, NY 11229-2633
Phone
(718) 360-6233
NPI assigned
Sep 9, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 763469 NY Primary

Addresses

Primary practice location

1863 Stuart St
Brooklyn, NY 11229-2633

Mailing address

1863 Stuart St
Brooklyn, NY 11229-2633
Phone (718) 339-0934

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

State licenses

LicenseStateTypeSpecialty
763469NYMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220918400000",
    "number": "1447408976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1863 STUART ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292633",
            "telephone_number": "718-339-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1863 STUART ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292633",
            "telephone_number": "718-360-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "MICHAEL",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "TSHH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-09",
        "last_updated": "2008-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "NY",
            "license": "763469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.