Active NPI
Deirdre Anna Mannix
- Speech-Language Pathologist
- Syosset, NY
National Provider Identifier
1669512240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 09119675
- Practice address
- 2 Calvert Dr
Syosset, NY 11791-2905 - Phone
- (516) 677-1994
- NPI assigned
- Feb 6, 2007
- Sex
- Male
- 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 | 09119675 | NY | Primary |
Addresses
Primary practice location
2 Calvert Dr
Syosset, NY 11791-2905
Mailing address
29 Main Ave
Sea Cliff, NY 11579-1311
Phone (516) 629-6349
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
| License | State | Type | Specialty |
|---|---|---|---|
| 09119675 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rosalie Menduni, Dba, East Norwich Therapeutic Services | Past | Accepting new patients | |
| East Norwich Therapeutic Services, OT, PC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Occupational Therapist
- Syosset, NY
- NPI 1295946713
-
- Early Intervention Provider Agency
- East Norwich, NY
- NPI 1356656052
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669512240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 MAIN AVE",
"city": "SEA CLIFF",
"state": "NY",
"postal_code": "115791311",
"telephone_number": "516-629-6349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 CALVERT DR",
"city": "SYOSSET",
"state": "NY",
"postal_code": "117912905",
"telephone_number": "516-677-1994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNIX",
"first_name": "DEIRDRE",
"middle_name": "ANNA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "09119675",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syosset, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.