Active NPI
Josephine Nicole Ezzo, M.A., CCC-SLP
- Speech-Language Pathologist
- Maspeth, NY
National Provider Identifier
1649580424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 020429-1
- Practice address
- 7002 54TH Ave
Maspeth, NY 11378-1745 - Phone
- (631) 669-8255
- NPI assigned
- Oct 14, 2010
- 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 | 020429-1 | NY | Primary |
Addresses
Primary practice location
7002 54TH Ave
Maspeth, NY 11378-1745
Mailing address
3554 Amherst Drive
Wantagh, NY 11793
Phone (631) 236-8046
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": "1287014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481241600000",
"number": "1649580424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3554 AMHERST DRIVE",
"city": "WANTAGH",
"state": "NY",
"postal_code": "11793",
"telephone_number": "631-236-8046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7002 54TH AVE",
"city": "MASPETH",
"state": "NY",
"postal_code": "113781745",
"telephone_number": "631-669-8255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZZO",
"first_name": "JOSEPHINE",
"middle_name": "NICOLE",
"credential": "M.A., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-14",
"last_updated": "2016-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "020429-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maspeth, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.