Larissa Canova

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS00525200 Issued in NJ

Practice address

45 Hillside Ave
Nutley, NJ 07110-1615

Phone

(201) 787-6669

NPI assigned

Jun 29, 2022

Last updated

Jun 29, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1639801475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 HILLSIDE AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101615",
            "telephone_number": "201-787-6669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 HILLSIDE AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101615",
            "telephone_number": "201-787-6669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANOVA",
        "first_name": "LARISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00525200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Nutley, NJ
• Providers in Nutley, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; 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.