Active NPI
Emily Gan
- Speech-Language Pathologist
- Jackson Heights, NY
National Provider Identifier
1689243248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 35-29 82ND Street
Jackson Heights, NY 11372 - Phone
- (718) 779-8800
- NPI assigned
- Jun 18, 2021
- Reactivated
- Sep 19, 2024
- Sex
- Female
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
35-29 82ND Street
Jackson Heights, NY 11372
Mailing address
35-29 82ND Street
Jackson Heights, NY 11372
Phone (718) 205-1919
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727222400000",
"number": "1689243248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35-29 82ND STREET",
"city": "JACKSON HEIGHTS",
"state": "NY",
"postal_code": "11372",
"telephone_number": "718-205-1919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35-29 82ND STREET",
"city": "JACKSON HEIGHTS",
"state": "NY",
"postal_code": "11372",
"telephone_number": "718-779-8800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAN",
"first_name": "EMILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-18",
"last_updated": "2024-09-25",
"certification_date": "2024-09-19",
"deactivation_date": "2024-09-03",
"reactivation_date": "2024-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson Heights, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.