Active NPI
Caroline Borrero-Tavarez, MS
- Speech-Language Pathologist
- Laurelton, NY
National Provider Identifier
1689417099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 034089-01
- Practice address
- 13056 Francis Lewis Blvd
Laurelton, NY 11413-1841 - Phone
- (917) 584-0787
- NPI assigned
- Jun 13, 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 | 034089-01 | NY | Primary |
Addresses
Primary practice location
13056 Francis Lewis Blvd
Laurelton, NY 11413-1841
Mailing address
6541 Saunders St Apt 5F
Rego Park, NY 11374-4205
Phone (917) 584-0787
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 034089-01 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727049600000",
"number": "1689417099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6541 SAUNDERS ST APT 5F",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113744205",
"telephone_number": "917-584-0787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13056 FRANCIS LEWIS BLVD",
"city": "LAURELTON",
"state": "NY",
"postal_code": "114131841",
"telephone_number": "917-584-0787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORRERO-TAVAREZ",
"first_name": "CAROLINE",
"name_prefix": "Mrs.",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-13",
"last_updated": "2024-09-23",
"certification_date": "2024-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "034089-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laurelton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.