Angelica Penagos Bolivar

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3783561 Issued in NY

Practice address

3420 94TH St
Flushing, NY 11372-3824

Phone

(718) 424-9031

NPI assigned

Dec 5, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1480896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1699219063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 PECONIC CT",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475305",
            "telephone_number": "631-742-6351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 94TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113723824",
            "telephone_number": "718-424-9031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENAGOS BOLIVAR",
        "first_name": "ANGELICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-05",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "3783561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ying Pei
• Latrice Pelissier, NP
• Genevieve Pena, OTR/L
• Yajaira R Pena
• Yolanda Pena
• Peninsula Day Care Inc
• Yael Penn
• Michelle Pennella
• Pension Committee Joint Industry Board
• Danielle Pepe, LMSW, PHD

• Speech-Language Pathologist in Flushing, NY
• Providers in Flushing, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; 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.