Kim Roman, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

54 Gladstone Ave
West Islip, NY 11795-3629

Phone

(631) 365-5821

NPI assigned

Aug 19, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kim Gallagher Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1780964908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 GLADSTONE AVE",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117953629",
            "telephone_number": "631-365-5821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 GLADSTONE AVE",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117953629",
            "telephone_number": "631-365-5821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "KIM",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "GALLAGHER",
            "credential": "M.S. CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert Sidney Schwartz M.D., PLLC
• Christine Karen Robles, D.O.
• Jenier Rodriguez
• Delia Rogu, MD
• Jonathan Alexander Roman, MSN, NP, CVRN-BC
• Gina Rommel
• Maryanne Rosario, DPT
• Cynthia Rosenthal, D.O.
• Peter Laurence Rosenthal, D.D.S.
• Christine A Rossner, L. AC.

• Speech-Language Pathologist in West Islip, NY
• Providers in West Islip, 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 Nov 30, 2016; 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.