Gina M. Oliva, S.L.P.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

14027571 Issued in NY

Practice address

367 Smith Rd
Lake Ronkonkoma, NY 11779-2206

Phone

(631) 831-1028

Fax

(631) 648-3442

NPI assigned

Jan 27, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Sachem Speech Incorporation

  • Speech-Language Pathologist
  • Lake Ronkonkoma, NY
  • NPI 1184974628
  NPD (past) Authorized official

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

{
    "created_epoch": "1296086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296086400000",
    "number": "1568768372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 SMITH RD",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117792206",
            "telephone_number": "631-831-1028",
            "fax_number": "631-648-3442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367 SMITH RD",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117792206",
            "telephone_number": "631-831-1028",
            "fax_number": "631-648-3442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVA",
        "first_name": "GINA",
        "middle_name": "M.",
        "credential": "S.L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-27",
        "last_updated": "2011-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "14027571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Shore Hematology Oncology Associates PC
• North Shore Medical Group of Mt Sinai School of Medicine
• Jack Z Nussbaum, MD
• Alyssandra Michelle O'Connell, MS
• Olivia O'Malley, NP
• Kyara Liz Ortiz, MSED
• Katherine Parente
• Nicholas Martin Pascullo, LPN
• Kundan A Patel
• Anthony Pavone

• Speech-Language Pathologist in Lake Ronkonkoma, NY
• Providers in Lake Ronkonkoma, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; 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.