Individual provider Active NPI

Mary Kish, SLP

  • Speech-Language Pathologist
  • Kenmore, NY
National Provider Identifier
1508021973
Registry record updated Jul 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
014939 Issued in NY
Practice address
2565 Elmwood Ave
Kenmore, NY 14217-1939
Phone
(716) 871-9915
NPI assigned
Jul 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 014939 NY Primary

Addresses

Primary practice location

2565 Elmwood Ave
Kenmore, NY 14217-1939

Mailing address

34 Sterling Ave
Buffalo, NY 14216-2808

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

LicenseStateTypeSpecialty
014939NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216857600000",
    "number": "1508021973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 STERLING AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142162808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2565 ELMWOOD AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171939",
            "telephone_number": "716-871-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISH",
        "first_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-24",
        "last_updated": "2008-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "014939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenmore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; 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.