Kristin Bevilacqua, Ma, CCC-SLP, PLLC

Primary specialty

Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X

License

0164531 Issued in NY

Legal business name

KRISTIN BEVILACQUA, MA, CCC-SLP, PLLC

Practice address

551 Jefferson Blvd
Staten Island, NY 10312-2225

Phone

(718) 208-9444

Fax

(718) 967-9513

NPI assigned

Mar 3, 2009

Last updated

Mar 3, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kristin Bevilacqua, MA, CCC-SLP

Title

Speech-Language Pathologist

Phone

(718) 208-9444

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236038400000",
    "number": "1568602563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 JEFFERSON BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103122225",
            "telephone_number": "718-208-9444",
            "fax_number": "718-967-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 JEFFERSON BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103122225",
            "telephone_number": "718-208-9444",
            "fax_number": "718-967-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTIN BEVILACQUA, MA, CCC-SLP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-03",
        "last_updated": "2009-03-03",
        "status": "A",
        "authorized_official_last_name": "BEVILACQUA",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "718-208-9444",
        "authorized_official_credential": "MA, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "NY",
            "license": "0164531",
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "0164531",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vaishali Krishnamoorthy, MD
• Deepa Krishnan, M.D.
• Sharila Krishnan, MD
• Veeraswamy Krishnaraj, M.D
• Kristen Hughes
• Elina Krivulets, M.D.
• Alexa Marie Kroczynski
• Oscar Krol
• Jaclyn Michelle Kronfeld
• Matthew Kroon

• Hearing and Speech Clinic/Center in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Hearing and Speech Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.

Verify at the official NPI Registry.