Individual provider Active NPI

Viktoria Eydelman-Grinn

  • Speech-Language Pathologist
  • Spring Valley, NY
National Provider Identifier
1750663159
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
012038 Issued in NY
Practice address
105 S Madison Ave
Spring Valley, NY 10977-5474
Phone
(845) 577-6000
NPI assigned
Sep 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 012038 NY Primary

Addresses

Primary practice location

105 S Madison Ave
Spring Valley, NY 10977-5474

Mailing address

105 S Madison Ave
Spring Valley, NY 10977-5474
Phone (845) 577-6000

Other names 1

  • Mrs. Viktoria Eydelman Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1750663159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S MADISON AVE",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109775474",
            "telephone_number": "845-577-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S MADISON AVE",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109775474",
            "telephone_number": "845-577-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EYDELMAN-GRINN",
        "first_name": "VIKTORIA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "012038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIKTORIA",
            "last_name": "EYDELMAN",
            "prefix": "MRS.",
            "credential": "M.S. CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spring Valley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.