Individual provider Active NPI

Bryna Dworetsky, SLP

  • Speech-Language Pathologist
  • Philadelphia, PA
National Provider Identifier
1629318522
Registry record updated Mar 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL009471 Issued in PA
Practice address
3975 Conshohocken Ave
Philadelphia, PA 19131-5426
Phone
(267) 292-6012
Fax
(215) 879-8424
NPI assigned
Mar 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2013

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 SL009471 PA Primary

Addresses

Primary practice location

3975 Conshohocken Ave
Philadelphia, PA 19131-5426

Mailing address

870 Foxfield Rd
Ambler, PA 19002-2081
Phone (215) 646-5411

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
SL009471PAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1362096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362096000000",
    "number": "1629318522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 FOXFIELD RD",
            "city": "AMBLER",
            "state": "PA",
            "postal_code": "190022081",
            "telephone_number": "215-646-5411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 CONSHOHOCKEN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191315426",
            "telephone_number": "267-292-6012",
            "fax_number": "215-879-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWORETSKY",
        "first_name": "BRYNA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-01",
        "last_updated": "2013-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL009471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; 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.