Active NPI
Nicole Elizabeth Pagnotta
- Speech-Language Pathologist
- Middle Village, NY
National Provider Identifier
1619607637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 033374
- Practice address
- 6910 65TH Dr
Middle Village, NY 11379-1708 - Phone
- (718) 326-6210
- NPI assigned
- Jun 13, 2022
- Sex
- Female
- Sole proprietor
- No
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 | 033374 | NY | Primary |
Addresses
Primary practice location
6910 65TH Dr
Middle Village, NY 11379-1708
Mailing address
6527 78TH St
Middle Village, NY 11379-2712
Phone (347) 835-3695
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
| License | State | Type | Specialty |
|---|---|---|---|
| 033374 | NY | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692144000000",
"number": "1619607637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6527 78TH ST",
"city": "MIDDLE VILLAGE",
"state": "NY",
"postal_code": "113792712",
"telephone_number": "347-835-3695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6910 65TH DR",
"city": "MIDDLE VILLAGE",
"state": "NY",
"postal_code": "113791708",
"telephone_number": "718-326-6210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGNOTTA",
"first_name": "NICOLE",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-13",
"last_updated": "2023-08-16",
"certification_date": "2023-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "033374",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middle Village, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.