Individual provider Active NPI

Mara Blorian, MA, CCC-SLP

  • Speech-Language Pathologist
  • Great Neck, NY
National Provider Identifier
1710352497
Registry record updated Dec 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
024212-1 Issued in NY
Practice address
15 Station Rd
Great Neck, NY 11023-2417
Phone
(516) 972-3520
NPI assigned
Dec 7, 2015
Last updated
Dec 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 024212-1 NY Primary
Speech-Language Pathologist 235Z00000X SL012236 PA

Addresses

Primary practice location

15 Station Rd
Great Neck, NY 11023-2417

Mailing address

15 Station Rd
Great Neck, NY 11023-2417
Phone (516) 972-3520

Other identifiers 1

IdentifierTypeStateIssuer
1OtherNYUPIN, MEDICARE, MEDICAID

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
024212NYMDOccupational Therapist
024212-1NYMDSpeech-Language Pathologist
SL012236PAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449446400000",
    "number": "1710352497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 STATION RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110232417",
            "telephone_number": "516-972-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 STATION RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110232417",
            "telephone_number": "516-972-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLORIAN",
        "first_name": "MARA",
        "name_prefix": "Ms.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-07",
        "last_updated": "2015-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "024212-1",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL012236",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN, MEDICARE, MEDICAID",
            "identifier": "1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2015; 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.