Irene Joyce Moog Dimatulac, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

14407950

Practice address

300 Adelphi St
Brooklyn, NY 11205-4601

Phone

(718) 858-6291

NPI assigned

Apr 3, 2024

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

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": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1801648738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 HART ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112373405",
            "telephone_number": "929-241-6951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ADELPHI ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112054601",
            "telephone_number": "718-858-6291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMATULAC",
        "first_name": "IRENE JOYCE",
        "middle_name": "MOOG",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "14407950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dimas Medical Care P.C.
• Paul Dimassi, DC
• Adriana Dimatteo, PSYD
• Mariam Dimatteo
• Richard Dimatteo
• Robert Morris Dimiceli, DPM
• Ignazio James Dimino, P.A.
• Laura Dimino
• Marcella Dimino
• Rosa Dimino, RPH

• Speech-Language Pathologist in Brooklyn, NY
• Providers in Brooklyn, 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 Apr 3, 2024; 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.