Individual provider Active NPI

Kim Elizabeth Andryshak, MS, CCC-SLP

  • Speech-Language Pathologist
  • Middletown, NY
National Provider Identifier
1801049515
Registry record updated Oct 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
008981-1 Issued in NY
Practice address
2 Elm Rd
Middletown, NY 10940-7208
Phone
(845) 386-2318
Fax
(845) 386-2318
NPI assigned
Oct 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2008

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 008981-1 NY Primary

Addresses

Primary practice location

2 Elm Rd
Middletown, NY 10940-7208

Mailing address

2 Elm Rd
Middletown, NY 10940-7208
Phone (845) 386-2318

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
008981-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1224806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224806400000",
    "number": "1801049515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 ELM RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109407208",
            "telephone_number": "845-386-2318",
            "fax_number": "845-386-2318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ELM RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109407208",
            "telephone_number": "845-386-2318",
            "fax_number": "845-386-2318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRYSHAK",
        "first_name": "KIM",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-24",
        "last_updated": "2008-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "008981-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2008; 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.