Stephanie Masullo

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

026031 Issued in NY

Practice address

458 Ackerson Blvd
Brightwaters, NY 11718-1714

Phone

(631) 942-2723

NPI assigned

Aug 11, 2015

Last updated

Aug 23, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1710353941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "458 ACKERSON BLVD",
            "city": "BRIGHTWATERS",
            "state": "NY",
            "postal_code": "117181714",
            "telephone_number": "631-942-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "458 ACKERSON BLVD",
            "city": "BRIGHTWATERS",
            "state": "NY",
            "postal_code": "117181714",
            "telephone_number": "631-942-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASULLO",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "026031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henny Liwan, M.D.
• Lona Wendy Lynn-Antonucci
• Kathleen Mary Manzolillo
• Michele Maratea, LAC
• Thomas Andrew Marchese, DPT
• Matrix Medical Wound Care PLLC
• Raymond Francis Mattfeld, P.T., A.T.C
• Patricia Ann McCarren, MS ED
• Angela McKelvey, RD, DTR
• Medical Qualified Service of Suffolk County New York PLLC (QSS New York Medical)

• Speech-Language Pathologist in Brightwaters, NY
• Providers in Brightwaters, 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 23, 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.