Alive Rehab Inc

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

ALIVE REHAB INC

Practice address

122-48 Milburn Street
Springfield Gardens, NY 11413-1033

Phone

(516) 312-3513

NPI assigned

Mar 7, 2023

Organization subpart

Yes

Parent organization

ALIVE REHAB INCAs reported in NPPES

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

Authorized official

Name

Mrs. Kerri-Ann Engala Austin de Castro, CCC-SLP

Title

Ceo/Speech-Language Pathologist

Phone

(516) 312-3513

Specialties & licenses 4

Addresses

Part of

Alive Rehab Inc

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

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1609576875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122-48 MILBURN STREET",
            "city": "SPRINGFIELD GARDENS",
            "state": "NY",
            "postal_code": "114131033",
            "telephone_number": "516-312-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122-48 MILBURN STREET",
            "city": "SPRINGFIELD GARDENS",
            "state": "NY",
            "postal_code": "114131033",
            "telephone_number": "516-312-3513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALIVE REHAB INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALIVE REHAB INC",
        "enumeration_date": "2023-03-07",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "AUSTIN DE CASTRO",
        "authorized_official_first_name": "KERRI-ANN",
        "authorized_official_middle_name": "ENGALA",
        "authorized_official_title_or_position": "CEO/SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "516-312-3513",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Springfield Gardens, 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 Mar 7, 2023; 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.