Active NPI
Vivian Jiang
- Speech-Language Pathologist
- Brooklyn, NY
National Provider Identifier
1760055495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 030761
- Practice address
- 1740 84TH St
Brooklyn, NY 11214-2825 - Phone
- (718) 885-8484
- NPI assigned
- Jul 20, 2021
- 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 | 030761 | NY | Primary |
Addresses
Primary practice location
1740 84TH St
Brooklyn, NY 11214-2825
Mailing address
1701 Avenue V
Brooklyn, NY 11229-4411
Phone (917) 868-1025
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | securerecords.sanford.html |
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 |
|---|---|---|---|
| 030761 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626739200000",
"number": "1760055495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 AVENUE V",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112294411",
"telephone_number": "917-868-1025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 84TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112142825",
"telephone_number": "718-885-8484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIANG",
"first_name": "VIVIAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-20",
"last_updated": "2021-07-20",
"certification_date": "2021-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "030761",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "securerecords.sanford.html",
"affiliation": "N",
"address_1": "1740 84th St",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112142825",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.