Individual provider Active NPI

Soroh Mizrachi, MA, SLP

  • Speech-Language Pathologist
  • Lakewood, NJ
National Provider Identifier
1629479027
Registry record updated Nov 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
152 Hadassah LN
Lakewood, NJ 08701-5560
Phone
(732) 551-7642
NPI assigned
Sep 4, 2014
Last updated
Nov 11, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NY
Speech-Language Pathologist 235Z00000X NJ Primary

Addresses

Primary practice location

152 Hadassah LN
Lakewood, NJ 08701-5560

Mailing address

152 Hadassah LN
Lakewood, NJ 08701-5560
Phone (732) 551-7642

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 Arts

NPI Registry JSON

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

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447200000000",
    "number": "1629479027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 HADASSAH LN",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015560",
            "telephone_number": "732-551-7642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 HADASSAH LN",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015560",
            "telephone_number": "732-551-7642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZRACHI",
        "first_name": "SOROH",
        "credential": "MA, SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-04",
        "last_updated": "2015-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2015; 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.