Kelly Elizabeth Roberts, M.A.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

52 3Rd Ave
Brentwood, NY 11717-4651

Phone

(631) 434-2123

NPI assigned

Oct 28, 2019

Sex

Female

Sole proprietor

No

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

Credentials

Master of Arts

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1609410133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 MANCHESTER LN",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902847",
            "telephone_number": "631-807-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 3RD AVE",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174651",
            "telephone_number": "631-434-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KELLY",
        "middle_name": "ELIZABETH",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rite Aid of New York Inc
• Josue Isai Rivas, LMT
• Norma Elizabeth Rivas, LPN
• Magali Rivera, LCSW
• Robert Dictrow DDS, Bruce S. Logue DDS, PC
• Mercila Roberty
• Wadlin Roberty
• Megan Robinson, RN
• Megan Patricia Rocker, LCSW, LMSW
• Gessy Sarai Rodriguez

• Speech-Language Pathologist in Brentwood, NY
• Providers in Brentwood, 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 Oct 28, 2019; 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.