Individual provider Active NPI

Bonnie Cassorla, SLP

  • Speech-Language Pathologist
  • Edison, NJ
National Provider Identifier
1710115225
Registry record updated Jul 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS00588900 Issued in NJ
Practice address
132 Evergreen Rd
NJ Veterans Memorial Home
Edison, NJ 08837-2484
Phone
(732) 452-4100
NPI assigned
Jun 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2009

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 41YS00588900 NJ Primary

Addresses

Primary practice location

132 Evergreen Rd
NJ Veterans Memorial Home
Edison, NJ 08837-2484

Mailing address

132 Evergreen Rd
NJ Veterans Memorial Home
Edison, NJ 08837-2484
Phone (718) 715-3400

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
41YS00588900NJMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247097600000",
    "number": "1710115225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 EVERGREEN RD",
            "address_2": "NJ VETERANS MEMORIAL HOME",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088372484",
            "telephone_number": "718-715-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 EVERGREEN RD",
            "address_2": "NJ VETERANS MEMORIAL HOME",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088372484",
            "telephone_number": "732-452-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSORLA",
        "first_name": "BONNIE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-24",
        "last_updated": "2009-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00588900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; 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.