Angel Deruvo, Ma CCC SLP PLLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

ANGEL DERUVO, MA CCC SLP PLLC

Practice address

47 Cedar Ter
Staten Island
Staten Island, NY 10304-1701

Phone

(917) 273-1448

NPI assigned

Jun 13, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Angel Deruvo, MA CCC SLPNPI 1851582175

Title

Speech Language Pathologist

Phone

(917) 273-1448

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Angel Deruvo, SLP MA CCC

  • Speech-Language Pathologist
  • Staten Island, NY
  • NPI 1851582175
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465776000000",
    "number": "1700235504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 CEDAR TER",
            "address_2": "STATEN ISLAND",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103041701",
            "telephone_number": "917-273-1448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 CEDAR TER",
            "address_2": "STATEN ISLAND",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103041701",
            "telephone_number": "917-273-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL DERUVO, MA CCC SLP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-13",
        "last_updated": "2016-06-13",
        "status": "A",
        "authorized_official_last_name": "DERUVO",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "917-273-1448",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA CCC SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Georgia Marie Angelo, FNP-BC

• Speech-Language Pathologist in Staten Island, NY
• Providers in Staten Island, 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 Jun 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.