Jeanine Marie Fasano, M.A., CCC-SLP, TSSLD

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

032063 Issued in NY

Practice address

77 N Centre Ave Ste 215
Rockville Centre, NY 11570-3923

Phone

(631) 363-5794

NPI assigned

Aug 26, 2021

Last updated

Aug 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Little Angels Center, Inc

  • Speech-Language Pathologist
  • Medford, NY
  • NPI 1588719041

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1740957810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HILDRETH PL",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107043009",
            "telephone_number": "914-346-0128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 N CENTRE AVE STE 215",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703923",
            "telephone_number": "631-363-5794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1909 Longfellow Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "10460",
            "country_code": "US",
            "telephone_number": "347-497-3998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FASANO",
        "first_name": "JEANINE",
        "middle_name": "MARIE",
        "credential": "M.A., CCC-SLP, TSSLD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-26",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "032063",
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Adam Falk, D.O.
• Fara Stricker Family Health Nurse Practitioner, P.C. (Pura Vida Medical)
• Sol Farkas, M.D.
• Walter M Farkas, MD
• Catherine Faro
• Rebecca Fatscher
• Alfred F. Faust, M.D.
• Shawna-Lee Tamar Feanny, NURSE PRACTITIONER
• John Martin Feder, MD
• Jessica Fegely

• Speech-Language Pathologist in Rockville Centre, NY
• Providers in Rockville Centre, 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 2, 2024; 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.