Individual provider Active NPI

Tiffany Molino

  • Speech-Language Pathologist
  • Staten Island, NY
National Provider Identifier
1669940623
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
029262 Issued in NY
Practice address
841 Father Capodanno Blvd
Staten Island, NY 10305-4039
Phone
(646) 321-8628
NPI assigned
Nov 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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 029262 NY Primary

Addresses

Primary practice location

841 Father Capodanno Blvd
Staten Island, NY 10305-4039

Mailing address

88 Jackson Ave Apt 203
Edison, NJ 08837-3165
Phone (646) 321-8628

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
029262NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Start Speech Pathology and Language PC Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1669940623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 JACKSON AVE APT 203",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088373165",
            "telephone_number": "646-321-8628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 FATHER CAPODANNO BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054039",
            "telephone_number": "646-321-8628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINO",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "029262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.