Tina Marie Bolger, M.A., CCC - SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

012388 Issued in NY

Practice address

11 Clove Lake PL
Staten Island, NY 10310-2712

Phone

(718) 981-8800

Fax

(718) 815-4677

NPI assigned

Nov 23, 2011

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 Arts

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1831466531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 KIMBERLY CT",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077264600",
            "telephone_number": "718-981-8800",
            "fax_number": "718-815-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CLOVE LAKE PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102712",
            "telephone_number": "718-981-8800",
            "fax_number": "718-815-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLGER",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC - SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-23",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "012388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heba Boktor
• Caryn Boland, RN
• Melanie Patrice Boland, RN
• Menelio Bolante, MD
• Mercy Bolay
• Nadya Bolgova, FNP-BC
• Amanda Rose Bollini
• Paul Bollmeyer, MD
• Dahlia Jeanetta Bolt, FNP
• Danamarie Bolusi

• Speech-Language Pathologist in Staten Island, NY
• Providers in Staten Island, 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 Nov 23, 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.