Active NPI
Jessica Krivac
- Speech-Language Pathologist
- Long Island City, NY
National Provider Identifier
1629511092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3514853
- Practice address
- 1-50 51St Avenue
Long Island City, NY 11101 - Phone
- (718) 609-3300
- NPI assigned
- Dec 2, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 3514853 | NY | Primary |
Addresses
Primary practice location
1-50 51St Avenue
Long Island City, NY 11101
Mailing address
1186 Bruce St
Franklin Square, NY 11010-1306
Phone (917) 930-4429
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 |
|---|---|---|---|
| 3514853 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480636800000",
"number": "1629511092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1186 BRUCE ST",
"city": "FRANKLIN SQUARE",
"state": "NY",
"postal_code": "110101306",
"telephone_number": "917-930-4429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1-50 51ST AVENUE",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "11101",
"telephone_number": "718-609-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRIVAC",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-12-02",
"last_updated": "2016-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "3514853",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Long Island City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.