Active NPI
Samantha Angelica Ayala, CCC-SLP
- Speech-Language Pathologist
- New York, NY
National Provider Identifier
1790459295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 41YS01087600
- Practice address
- 726 Broadway FL 5
New York, NY 10003-9616 - Phone
- (201) 618-9041
- NPI assigned
- Aug 6, 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 | 41YS01087600 | NJ | Primary |
Addresses
Primary practice location
726 Broadway FL 5
New York, NY 10003-9616
Mailing address
630 Chestnut St
Kearny, NJ 07032-2912
Phone (201) 618-9041
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 |
|---|---|---|---|
| 41YS01087600 | NJ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630972800000",
"number": "1790459295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 CHESTNUT ST",
"city": "KEARNY",
"state": "NJ",
"postal_code": "070322912",
"telephone_number": "201-618-9041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "726 BROADWAY FL 5",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100039616",
"telephone_number": "201-618-9041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AYALA",
"first_name": "SAMANTHA",
"middle_name": "ANGELICA",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-06",
"last_updated": "2021-09-07",
"certification_date": "2021-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NJ",
"license": "41YS01087600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.