Active NPI
Marian B Boehm
- Speech-Language Pathologist
- Sea Cliff, NY
National Provider Identifier
1730324567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 002704-1
- Practice address
- 30 Clinton St
Sea Cliff, NY 11579-1820 - Phone
- (516) 671-4561
- Fax
- (516) 674-6085
- NPI assigned
- Dec 8, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 002704-1 | NY | Primary |
Addresses
Primary practice location
30 Clinton St
Sea Cliff, NY 11579-1820
Mailing address
30 Clinton St
Sea Cliff, NY 11579-1820
Phone (516) 671-4561
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
| License | State | Type | Specialty |
|---|---|---|---|
| 002704-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400803200000",
"number": "1730324567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 CLINTON ST",
"city": "SEA CLIFF",
"state": "NY",
"postal_code": "115791820",
"telephone_number": "516-671-4561",
"fax_number": "516-674-6085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 CLINTON ST",
"city": "SEA CLIFF",
"state": "NY",
"postal_code": "115791820",
"telephone_number": "516-671-4561",
"fax_number": "516-674-6085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOEHM",
"first_name": "MARIAN",
"middle_name": "B",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-08",
"last_updated": "2014-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "002704-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sea Cliff, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.