Active NPI
Alena R Davydova
- Speech-Language Pathologist
- Forest Hills, NY
National Provider Identifier
1801103585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 11945 Union Tpke
Forest Hills, NY 11375-6144 - Phone
- (718) 263-5500
- NPI assigned
- Sep 1, 2010
- Sex
- Female
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
11945 Union Tpke
Forest Hills, NY 11375-6144
Mailing address
1773 W 12TH St
Brooklyn, NY 11223-1145
Phone (718) 372-8669
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| VB21170R | Medicaid | NY |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283299200000",
"number": "1801103585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1773 W 12TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112231145",
"telephone_number": "718-372-8669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11945 UNION TPKE",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113756144",
"telephone_number": "718-263-5500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVYDOVA",
"first_name": "ALENA",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-01",
"last_updated": "2010-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "VB21170R",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.