Individual provider Active NPI

Lisa Ann Spiryda

  • Speech-Language Pathologist
  • Port Washington, NY
National Provider Identifier
1679888440
Registry record updated Aug 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
013270-1 Issued in NY
Practice address
9 Poplar PL
Port Washington, NY 11050-1812
Phone
(516) 767-0580
NPI assigned
Aug 17, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2010

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 013270-1 NY Primary

Addresses

Primary practice location

9 Poplar PL
Port Washington, NY 11050-1812

Mailing address

9 Poplar PL
Port Washington, NY 11050-1812
Phone (516) 767-0580

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
013270-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282003200000",
    "number": "1679888440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 POPLAR PL",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110501812",
            "telephone_number": "516-767-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 POPLAR PL",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110501812",
            "telephone_number": "516-767-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIRYDA",
        "first_name": "LISA ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2010-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "013270-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2010; 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.