Bruce Engholm, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

008296-1 Issued in NY

Practice address

4 Yankee PL
Ellenville, NY 12428-1510

Phone

(845) 647-6464

NPI assigned

Sep 3, 2010

Last updated

Sep 3, 2010By the provider in NPPES

Sex

Male

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)

Enrolled

State licenses

Practice roles

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.

• Center for Spectrum Services

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  • NPI 1922251313
  NPD (past)
• Federation Employment and Guidance Service, Inc

  • Developmental Disabilities Clinic/Center
  • New York, NY
  • NPI 1942243084
  NPD (past)
• Essential Therapy Services of NJ

  • Occupational Therapist
  • Rockaway, NJ
  • NPI 1730852070

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283472000000",
    "number": "1851608350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 KUKUK LN",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124016943",
            "telephone_number": "845-336-2616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 YANKEE PL",
            "city": "ELLENVILLE",
            "state": "NY",
            "postal_code": "124281510",
            "telephone_number": "845-647-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGHOLM",
        "first_name": "BRUCE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-03",
        "last_updated": "2010-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "008296-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Ducker
• Ellenville Central School District
• Ellenville Emergency Medical Associates PLLC
• Ellenville First Aid & Rescue Squad Inc
• Ellenville Medical Group
• Erh Specialty Practice
• Lina Maria Escobar, O.D.
• Finding My Solutions LLC
• Julie Beth Fineman, PT
• Elizabeth Rose Finger

• Speech-Language Pathologist in Ellenville, NY
• Providers in Ellenville, 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 Sep 3, 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.

Verify at the official NPI Registry.