Individual provider Active NPI

Lisa S Nieradka, SPEECH PATHOLOGIST

  • Speech-Language Pathologist
  • Clifton Park, NY
National Provider Identifier
1467734798
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
060997-1 Issued in NY
Practice address
948 Route 146
Clifton Park, NY 12065-3614
Phone
(518) 881-0540
NPI assigned
Sep 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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 060997-1 NY Primary

Addresses

Primary practice location

948 Route 146
Clifton Park, NY 12065-3614

Mailing address

948 Route 146
Clifton Park, NY 12065-3614
Phone (518) 881-0540

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
060997-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1467734798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "948 ROUTE 146",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653614",
            "telephone_number": "518-881-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "948 ROUTE 146",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653614",
            "telephone_number": "518-881-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIERADKA",
        "first_name": "LISA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "SPEECH PATHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "060997-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.