Meredith Leslie Bushell, SPEECH PATHOLOGIST

Key facts

NPI

1487265385

Entity type

Individual (NPI type 1)

Primary specialty

Speech-Language Pathologist 235Z00000X

Practice address

76 Roberts Path
Wading River, NY 11792-2177

Phone

(631) 513-0760

NPI assigned

Aug 13, 2020

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 13, 2020.

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1487265385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 ROBERTS PATH",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922177",
            "telephone_number": "631-513-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 ROBERTS PATH",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922177",
            "telephone_number": "631-513-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHELL",
        "first_name": "MEREDITH",
        "middle_name": "LESLIE",
        "name_prefix": "Ms.",
        "credential": "SPEECH PATHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wading River, NY

• Diane Marie Brayer, RN
• Charles Breitstadt, PHARMD
• Jon Neil Brodbeck, D.C.
• Tesia Marie Brooks, LMSW
• Myles Buhner, PHARMD
• C Jay'S Management Corporation
• Lorraine Callas, A.N.P.
• Jeffrey P Campisi, DDS
• Allyson Carlson, PSYD
• Kayla B Carrasquillo, MASTER OF SCIENCE

All providers in Wading River, NY · Speech-Language Pathologist in New York