Individual provider Active NPI

Eileen Sullivan-Wolfson

  • Speech-Language Pathologist
  • Bronx, NY
National Provider Identifier
1649713405
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
019909-1 Issued in NY
Practice address
2151 Washington Ave
Bronx, NY 10457-2506
Phone
(718) 584-3992
NPI assigned
Nov 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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 019909-1 NY Primary

Addresses

Primary practice location

2151 Washington Ave
Bronx, NY 10457-2506

Mailing address

236 W 259TH St
Bronx, NY 10471-1924
Phone (718) 584-3992

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

LicenseStateTypeSpecialty
019909-1NYMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1649713405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 W 259TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104711924",
            "telephone_number": "718-584-3992",
            "fax_number": "718-584-7252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 WASHINGTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572506",
            "telephone_number": "718-584-3992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN-WOLFSON",
        "first_name": "EILEEN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-28",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "019909-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.

Verify at the official NPI Registry.