Kerrin Maureen McBreen, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

015987-1 Issued in NY

Practice address

103 Arlington Rd
Lake Ronkonkoma, NY 11779-1641

Phone

(631) 648-4480

Fax

(631) 648-4480

NPI assigned

Mar 2, 2009

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1235952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235952000000",
    "number": "1477793644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 ARLINGTON RD",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117791641",
            "telephone_number": "631-648-4480",
            "fax_number": "631-648-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 ARLINGTON RD",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117791641",
            "telephone_number": "631-648-4480",
            "fax_number": "631-648-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBREEN",
        "first_name": "KERRIN",
        "middle_name": "MAUREEN",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-02",
        "last_updated": "2009-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "015987-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen Marino Clark, MS
• Kelly Teresa Marvullo
• Barbara Massaro, LMHC
• Robert Frederick Mazzeo, MD
• Fiona McBreen, LMSW
• Michael James McGovern, O.D.
• Meagan McGuigan, L.P.N.
• Jenna M McKenzie, FNP
• Nicole McLaughlin
• Medi Active Wheels LLC

• Speech-Language Pathologist in Lake Ronkonkoma, NY
• Providers in Lake Ronkonkoma, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; 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.