Individual provider Active NPI

Miriam Kolodny, SLP

  • Speech-Language Pathologist
  • Lakewood, NJ
National Provider Identifier
1699002154
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS00606900 Issued in NJ
Practice address
130 Leonard St
Lakewood, NJ 08701-2049
Phone
(732) 905-0725
Fax
(732) 377-5484
NPI assigned
Nov 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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 41YS00606900 NJ Primary

Addresses

Primary practice location

130 Leonard St
Lakewood, NJ 08701-2049

Mailing address

1 Newberry CT
Lakewood, NJ 08701-5402
Phone (848) 525-2081

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
41YS00606900NJMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Language Builders, Inc 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": "1257292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1699002154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 NEWBERRY CT",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015402",
            "telephone_number": "848-525-2081",
            "fax_number": "732-377-5484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 LEONARD ST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087012049",
            "telephone_number": "732-905-0725",
            "fax_number": "732-377-5484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLODNY",
        "first_name": "MIRIAM",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-04",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00606900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; 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.