Tara B Nelsen, SLP, PC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

015795 Issued in NY

Legal business name

TARA B NELSEN, SLP, PC

Practice address

189 Park Ave
Park Ridge, NJ 07656-1339

Phone

(914) 420-6896

NPI assigned

Nov 17, 2008

Last updated

Nov 17, 2008By 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

Ms. Tara Nelsen-DefalcoNPI 1538313630

Title

President

Phone

(914) 420-6896

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tara Nelsen-Defalco

  • Speech-Language Pathologist
  • Park Ridge, NJ
  • NPI 1538313630
  NPD (past) Authorized official

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226880000000",
    "number": "1588818686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 PARK AVE",
            "city": "PARK RIDGE",
            "state": "NJ",
            "postal_code": "076561339",
            "telephone_number": "914-420-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 PARK AVE",
            "city": "PARK RIDGE",
            "state": "NJ",
            "postal_code": "076561339",
            "telephone_number": "914-420-6896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARA B NELSEN, SLP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-17",
        "last_updated": "2008-11-17",
        "status": "A",
        "authorized_official_last_name": "NELSEN-DEFALCO",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-420-6896",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "015795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassandra Courtney Jeanne Soluri, LSW
• Amanda Soran, M.S., CCC-SLP
• Hayley Rose Soranno
• Jaime Stine, M.S., BCBA
• Deirdre Tallman, OTR/L
• The Smile Stop LLC
• Nicholas Carmine Todaro
• Eric Roy Von Der Lieth
• Erica Mihe Von Der Lieth, D.C.
• Sonia Vulakh, D.D.S

• Speech-Language Pathologist in Park Ridge, NJ
• Providers in Park Ridge, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.