Individual provider Active NPI

Stacy Danielle Pelofsky, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Huntington, NY
National Provider Identifier
1629389481
Registry record updated Jun 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
019066-1 Issued in NY
Practice address
25 Little Plains Rd
Huntington, NY 11743-4550
Phone
(631) 266-4425
NPI assigned
Jun 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2010

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 019066-1 NY Primary

Addresses

Primary practice location

25 Little Plains Rd
Huntington, NY 11743-4550

Mailing address

99 Hollywood Dr
Smithtown, NY 11787-3135

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
019066-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1277596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277596800000",
    "number": "1629389481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 HOLLYWOOD DR",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 LITTLE PLAINS RD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117434550",
            "telephone_number": "631-266-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELOFSKY",
        "first_name": "STACY",
        "middle_name": "DANIELLE",
        "name_prefix": "Ms.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-27",
        "last_updated": "2010-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "019066-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2010; 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.