Individual provider Active NPI

Fany Herrera Jara

  • Speech-Language Pathologist
  • Cliffside Park, NJ
National Provider Identifier
1790060523
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
019565-1 Issued in NY
Practice address
301 Lafayette Ave
Apt 3C
Cliffside Park, NJ 07010-2559
Phone
(917) 349-6132
NPI assigned
Oct 12, 2011
Last updated
Oct 12, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 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 019565-1 NY Primary

Addresses

Primary practice location

301 Lafayette Ave
Apt 3C
Cliffside Park, NJ 07010-2559

Mailing address

301 Lafayette Ave
Apt 3C
Cliffside Park, NJ 07010-2559
Phone (917) 349-6132

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
019565-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1790060523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LAFAYETTE AVE",
            "address_2": "APT 3C",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070102559",
            "telephone_number": "917-349-6132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 LAFAYETTE AVE",
            "address_2": "APT 3C",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070102559",
            "telephone_number": "917-349-6132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERA JARA",
        "first_name": "FANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-12",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "019565-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cliffside Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.