NPIMap

Organization Active NPI

Long Island Speech Pathology Myofunctional Therapy Services P.C.

  • Speech-Language Pathologist
  • Jericho, NY
National Provider Identifier
1720761224
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
LONG ISLAND SPEECH PATHOLOGY MYOFUNCTIONAL THERAPY SERVICES P.C.
Practice address
500 N Broadway Ste 141
Jericho, NY 11753-2111
Phone
(631) 689-6858
NPI assigned
Aug 10, 2023
Last updated
Aug 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Authorized official

Name
Janine StieneNPI 1801971502
Title
President
Phone
(631) 689-6858

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

500 N Broadway Ste 141
Jericho, NY 11753-2111

Mailing address

10 Sean LN
Mount Sinai, NY 11766-1847
Phone (631) 689-6858

National Provider Directory

National Provider Directory

Locations

500 N Broadway
Ste 141
Jericho, NY 11753
Phone (516) 597-4344

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691625600000",
    "number": "1720761224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SEAN LN",
            "city": "MOUNT SINAI",
            "state": "NY",
            "postal_code": "117661847",
            "telephone_number": "631-689-6858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N BROADWAY STE 141",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117532111",
            "telephone_number": "631-689-6858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND SPEECH PATHOLOGY MYOFUNCTIONAL THERAPY SERVICES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A",
        "authorized_official_last_name": "STIENE",
        "authorized_official_first_name": "JANINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-689-6858"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jericho, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.