Shrub Oak Clinical Services OT, PT, SLP, LMSW, Psychology, PLLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

02141 Issued in NY

Legal business name

SHRUB OAK CLINICAL SERVICES OT, PT, SLP, LMSW, PSYCHOLOGY, PLLC

Practice address

80 Broad St Ste 1702
New York, NY 10004-2248

Phone

(212) 867-2922

NPI assigned

Aug 17, 2018

Organization subpart

No

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

Authorized official

Name

Ms. Lori Koffler, SLP

Title

President

Phone

(917) 696-2171

Specialties & licenses 6

Addresses

Other identifiers 5

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1699255844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 BROAD ST STE 1702",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042248",
            "telephone_number": "212-867-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 BROAD ST STE 1702",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042248",
            "telephone_number": "212-867-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHRUB OAK CLINICAL SERVICES OT, PT, SLP, LMSW, PSYCHOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "KOFFLER",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-696-2171",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NY",
            "license": "014220",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "097381",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "035660",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "016818",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "02141",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "002141",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE EDUCATION DEPARTMENT",
            "identifier": "016818",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE EDUCATION DEPARTMENT",
            "identifier": "035660",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE EDUCATION DEPARTMENT",
            "identifier": "014220",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE EDUCATION DEPARTMENT",
            "identifier": "002141",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE EDUCATION DEPARTMENT",
            "identifier": "097381",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diya Shroff
• Nupoor Shroff
• Charlotte Diamond Shron, RD
• Ritu Shrotriya, M.D.
• Laura Diane Shroyer, NP
• Alyssa Lee Shruhan, LMSW
• Aditi Shruti, MD
• Neelu Shruti
• Brian Shtab
• Michael Shtabsky, MD

• Speech-Language Pathologist in New York, NY
• Providers in New York, 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 Aug 17, 2018; 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.