Active NPI
Mary Lee-Vang
- Speech-Language Pathologist
- Syracuse, NY
National Provider Identifier
1497080402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 018866-1
- Practice address
- 1951 Caleb Ave
Syracuse, NY 13206-2560 - Phone
- (315) 218-7444
- Fax
- (315) 218-7466
- NPI assigned
- Oct 8, 2009
- Sex
- Female
- Sole proprietor
- No
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 | 018866-1 | NY | Primary |
Addresses
Primary practice location
1951 Caleb Ave
Syracuse, NY 13206-2560
Mailing address
7716 Anchor Dr
Liverpool, NY 13090-2639
Phone (315) 218-7444
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018866-1 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapy Partners in OT, PT, and Speech-Language Pathology, PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Early Intervention Provider Agency
- Syracuse, NY
- NPI 1194977363
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254960000000",
"number": "1497080402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7716 ANCHOR DR",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130902639",
"telephone_number": "315-218-7444",
"fax_number": "315-218-7466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1951 CALEB AVE",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132062560",
"telephone_number": "315-218-7444",
"fax_number": "315-218-7466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE-VANG",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-08",
"last_updated": "2009-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "018866-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.