Individual provider Active NPI

Richard Lawrence Angelillo

  • Speech-Language Pathologist
  • Eatontown, NJ
National Provider Identifier
1780192443
Registry record updated Jan 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS00835300 Issued in NJ
Practice address
1 Main St Ste 505
Eatontown, NJ 07724-3903
Phone
(267) 471-0516
NPI assigned
Jan 16, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2018

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 41YS00835300 NJ Primary

Addresses

Primary practice location

1 Main St Ste 505
Eatontown, NJ 07724-3903

Mailing address

1 Main St Ste 505
Eatontown, NJ 07724-3903

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

LicenseStateTypeSpecialty
41YS00835300NJMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516060800000",
    "number": "1780192443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MAIN ST STE 505",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077243903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAIN ST STE 505",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077243903",
            "telephone_number": "267-471-0516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELILLO",
        "first_name": "RICHARD",
        "middle_name": "LAWRENCE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-16",
        "last_updated": "2018-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00835300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eatontown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2018; 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.