Individual provider Active NPI

Stacy Ann Lebov

  • Speech-Language Pathologist
  • Long Beach, NY
National Provider Identifier
1679610935
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
008988-1 Issued in NY
Practice address
55 Monroe Blvd Apt 5G
Long Beach, NY 11561-4307
Phone
(516) 449-2891
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 008988-1 NY Primary

Addresses

Primary practice location

55 Monroe Blvd Apt 5G
Long Beach, NY 11561-4307

Mailing address

55 Monroe Blvd
Apt 5G
Long Beach, NY 11561
Phone (516) 449-2891

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
008988-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679610935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MONROE BLVD",
            "address_2": "APT 5G",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "11561",
            "telephone_number": "516-449-2891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MONROE BLVD APT 5G",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115614307",
            "telephone_number": "516-449-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBOV",
        "first_name": "STACY",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "008988-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, 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.

Verify at the official NPI Registry.