Kelley Schupak

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS00853700 Issued in NJ

Practice address

5-11 Saddle River Rd
Fair Lawn, NJ 07410-5635

Phone

(201) 509-8205

NPI assigned

Jan 17, 2017

Last updated

Jan 17, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Speech Therapy Plus LLC

  • Speech-Language Pathologist
  • Fair Lawn, NJ
  • NPI 1821534850
  NPD (past)

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1467998211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 GRANDVIEW AVE",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070901629",
            "telephone_number": "908-577-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5-11 SADDLE RIVER RD",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074105635",
            "telephone_number": "201-509-8205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUPAK",
        "first_name": "KELLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-17",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00853700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Schoemer, LSW
• Dennis Schoen, LCSW
• Marc Schoenbrun, M.D.
• Patrice Renee Schoenbrun, D.D.S.
• Cheryl M Schrader, LCSW
• Michael Christopher Sciacca, MPT
• Nicole Michel Scillia, APN
• Sears Podiatry PC
• Sebrow Laser Vision PA (Park Avenue Eye MD)
• Snehi Sehgal Kapur, M.D.

• Speech-Language Pathologist in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.

Verify at the official NPI Registry.