Individual provider Active NPI

Jordan Maris Dictrow

  • Speech-Language Pathologist
  • Brooklyn, NY
National Provider Identifier
1649108580
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
1412 Avenue J Apt 3C
Brooklyn, NY 11230-3747
Phone
(718) 814-7200
NPI assigned
May 11, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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 Primary

Addresses

Primary practice location

1412 Avenue J Apt 3C
Brooklyn, NY 11230-3747

Mailing address

5 Salem CT
Marlboro, NJ 07746-2620

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

NPI Registry JSON

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

{
    "created_epoch": "1778457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1649108580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SALEM CT",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077462620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 AVENUE J APT 3C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112303747",
            "telephone_number": "718-814-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICTROW",
        "first_name": "JORDAN",
        "middle_name": "MARIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-11",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; 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.