Active NPI
Elaine Bernabe Gonzalez, MS CCC-SLP
- Speech-Language Pathologist
- Richmond Hill, NY
National Provider Identifier
1467782458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 015897-1
- Practice address
- 11624 Grosvenor LN
Apt 3a
Richmond Hill, NY 11418-3450 - Phone
- (347) 806-3582
- NPI assigned
- Jan 13, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 015897-1 | NY | Primary |
Addresses
Primary practice location
11624 Grosvenor LN
Apt 3a
Richmond Hill, NY 11418-3450
Mailing address
11624 Grosvenor LN
Apt 3a
Richmond Hill, NY 11418-3450
Phone (347) 806-3582
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015897-1 | NY | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484265600000",
"number": "1467782458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11624 GROSVENOR LN",
"address_2": "APT 3A",
"city": "RICHMOND HILL",
"state": "NY",
"postal_code": "114183450",
"telephone_number": "347-806-3582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11624 GROSVENOR LN",
"address_2": "APT 3A",
"city": "RICHMOND HILL",
"state": "NY",
"postal_code": "114183450",
"telephone_number": "347-806-3582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "ELAINE",
"middle_name": "BERNABE",
"credential": "MS CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-13",
"last_updated": "2017-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "015897-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond Hill, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.