Active NPI
Michelle Ann Redino, MS CCC NYS LIC SLP
- Speech-Language Pathologist
- Buffalo, NY
National Provider Identifier
1578877916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 004960-1
- Practice address
- 126 Donaldson Rd
Buffalo, NY 14208 - Phone
- (716) 816-3490
- Fax
- (716) 888-7109
- NPI assigned
- Jul 27, 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 | 004960-1 | NY | Primary |
Addresses
Primary practice location
126 Donaldson Rd
Buffalo, NY 14208
Mailing address
116 Londerry LN
Getzville, NY 14068-1168
Phone (716) 639-0908
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004960-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280188800000",
"number": "1578877916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 LONDERRY LN",
"city": "GETZVILLE",
"state": "NY",
"postal_code": "140681168",
"telephone_number": "716-639-0908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "126 DONALDSON RD",
"city": "BUFFALO",
"state": "NY",
"postal_code": "14208",
"telephone_number": "716-816-3490",
"fax_number": "716-888-7109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDINO",
"first_name": "MICHELLE",
"middle_name": "ANN",
"credential": "MS CCC NYS LIC SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-27",
"last_updated": "2010-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "004960-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.