Angel Deruvo, SLP MA CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

58014493 Issued in NY

Practice address

47 Cedar Terrace
Staten Island, NY 10304

Phone

(817) 273-1448

Fax

(718) 442-7641

NPI assigned

Aug 5, 2007

Last updated

Jan 25, 2016By the provider in NPPES

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

Other names 1

• Mrs. Angel Deruvo Other name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Angel Deruvo, Ma CCC SLP PLLC

  • Speech-Language Pathologist
  • Staten Island, NY
  • NPI 1700235504
  Medicare reassignment NPD Authorized official
• Angel Deruvo PLLC

  • Speech-Language Pathologist
  • Staten Island, NY
  • NPI 1487013116
  NPD (past) Authorized official
• Welllife Network Inc.

  • Case Management Agency
  • Coram, NY
  • NPI 1386817906
  NPD (past)

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1851582175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 CEDAR TERRACE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10304",
            "telephone_number": "817-273-1448",
            "fax_number": "718-442-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 CEDAR TERRACE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10304",
            "telephone_number": "817-273-1448",
            "fax_number": "718-442-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERUVO",
        "first_name": "ANGEL",
        "name_prefix": "Ms.",
        "credential": "SLP MA CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "58014493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGEL",
            "last_name": "DERUVO",
            "prefix": "MRS.",
            "credential": "SLP MA CCC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Samantha Deriso, LPN
• Jenna Nicole Derleth, OT
• Denise Derosa, PT
• Ericka Derose
• Jelani Charles Derrick, RN
• Bhavita Desai, MD
• Harshadray Desai
• Kinjal N Desai, OTR/L
• Tejal Desai, DO
• Vinay Desai, M.D.

• 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 Jan 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.