Active NPI
Carmen Enid Medina
- Speech-Language Pathologist
- Bronx, NY
National Provider Identifier
1508169673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 006423-1
- Practice address
- 2340 Andrews Ave
Bronx, NY 10468-6001 - Phone
- (718) 365-7238
- Fax
- (718) 584-3057
- NPI assigned
- Dec 13, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | 006423-1 | NY | Primary |
Addresses
Primary practice location
2340 Andrews Ave
Bronx, NY 10468-6001
Mailing address
22 Riverview Ave
Ardsley, NY 10502-2317
Phone (914) 693-0149
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 |
|---|---|---|---|
| 006423-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292198400000",
"number": "1508169673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 RIVERVIEW AVE",
"city": "ARDSLEY",
"state": "NY",
"postal_code": "105022317",
"telephone_number": "914-693-0149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2340 ANDREWS AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104686001",
"telephone_number": "718-365-7238",
"fax_number": "718-584-3057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "CARMEN",
"middle_name": "ENID",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-12-13",
"last_updated": "2010-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "006423-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.