Individual provider Active NPI

Debra Wieder

  • Speech-Language Pathologist
  • Brooklyn, NY
National Provider Identifier
1619122165
Registry record updated Nov 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
015984-1 Issued in NY
Practice address
1651-57 Ralph Ave
Brooklyn, NY 11236
Phone
(718) 241-9211
NPI assigned
Nov 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 015984-1 NY Primary

Addresses

Primary practice location

1651-57 Ralph Ave
Brooklyn, NY 11236

Mailing address

1363 E 26TH St
Brooklyn, NY 11210-5240
Phone (718) 252-7023

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

State licenses

LicenseStateTypeSpecialty
015984-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227571200000",
    "number": "1619122165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1363 E 26TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112105240",
            "telephone_number": "718-252-7023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651-57 RALPH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11236",
            "telephone_number": "718-241-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDER",
        "first_name": "DEBRA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-25",
        "last_updated": "2008-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "015984-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.