NPIMap

Organization Active NPI

Legendary Speech Pathology PLLC

Doing business as Legendary Therapy

  • Early Intervention Provider Agency
  • Staten Island, NY
National Provider Identifier
1639578107
Registry record updated Aug 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
011183 Issued in NY
Legal business name
LEGENDARY SPEECH PATHOLOGY PLLC
Doing business as
Legendary Therapy
Practice address
997 Stafford Ave
Staten Island, NY 10309-2109
Phone
(718) 948-1900
NPI assigned
Aug 20, 2014
Last updated
Aug 20, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2014

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

Authorized official

Name
Mrs. Rachel WeissNPI 1538313960
Title
Director
Phone
(917) 744-3976

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 011183 NY Primary

Addresses

Primary practice location

997 Stafford Ave
Staten Island, NY 10309-2109

Mailing address

997 Stafford Ave
Staten Island, NY 10309-2109
Phone (718) 948-1900

Other names 1

  • Legendary Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Legendary Speech Pathology PLLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408492800000",
    "number": "1639578107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "997 STAFFORD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103092109",
            "telephone_number": "718-948-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "997 STAFFORD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103092109",
            "telephone_number": "718-948-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGENDARY SPEECH PATHOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-20",
        "last_updated": "2014-08-20",
        "status": "A",
        "authorized_official_last_name": "WEISS",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "917-744-3976",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "011183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legendary Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.