Individual provider Active NPI

Janielle Zinna Kovacik, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Nyack, NY
National Provider Identifier
1629214259
Registry record updated Aug 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
011922 Issued in NY
Practice address
248 Depew Ave Apt 2
Nyack, NY 10960-2968
Phone
(845) 893-9102
NPI assigned
Jan 3, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2014

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 011922 NY Primary

Addresses

Primary practice location

248 Depew Ave Apt 2
Nyack, NY 10960-2968

Mailing address

248 Depew Ave Apt 2
Nyack, NY 10960-2968
Phone (845) 893-9102

Other identifiers 1

IdentifierTypeStateIssuer
03660102MedicaidNY

Other names 1

  • Miss Janielle Zinna Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
011922NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1230940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409270400000",
    "number": "1629214259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 DEPEW AVE APT 2",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109602968",
            "telephone_number": "845-893-9102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 DEPEW AVE APT 2",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109602968",
            "telephone_number": "845-893-9102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACIK",
        "first_name": "JANIELLE",
        "middle_name": "ZINNA",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-03",
        "last_updated": "2014-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "011922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03660102",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANIELLE",
            "last_name": "ZINNA",
            "prefix": "MISS",
            "credential": "M.S., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Nyack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; 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.