Ilissa Abovitz, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL015695 Issued in PA

Practice address

295 Buck Rd Ste 203
Southampton, PA 18966-1748

Phone

(215) 485-5018

NPI assigned

Sep 21, 2021

Last updated

Sep 21, 2021By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1487325361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 MULBERRY DR",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189662856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 BUCK RD STE 203",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189661748",
            "telephone_number": "215-485-5018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOVITZ",
        "first_name": "ILISSA",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00869700",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL015695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A & M Medical Supply, Inc
• Aaron Shiloh, MD LLC
• Abington Memorial Hospital (Medical Associates of Southampton)
• Abington Memorial Hospital (Jerry M. Roth M.D. F.A.C.P.)
• Abington Memorial Hospital (BuxMont Primary Care)
• Allison Abraham, PSY.D.
• Absolute Smile
• Absolute Wellness & Beauty
• Ace Care Inc
• Ace Transit Management LLC

• Speech-Language Pathologist in Southampton, PA
• Providers in Southampton, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.