NPIMap

Organization Active NPI

Eastern Li Speech Pathology &Swallowing Disorders PC

  • Speech-Language Pathologist
  • East Yaphank, NY
National Provider Identifier
1851694483
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
011861 Issued in NY
Legal business name
EASTERN LI SPEECH PATHOLOGY &SWALLOWING DISORDERS PC
Practice address
1500 William Floyd Pkwy
Suite 303
East Yaphank, NY 11967-1800
Phone
(631) 775-8203
Fax
(631) 775-8202
NPI assigned
Dec 21, 2010
Last updated
Jul 16, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Janine Stiene, SLPNPI 1801971502
Title
Owner
Phone
(631) 689-6858

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 011861 NY Primary

Addresses

Primary practice location

1500 William Floyd Pkwy
Suite 303
East Yaphank, NY 11967-1800

Mailing address

1500 William Floyd Pkwy
Suite 303
East Yaphank, NY 11967-1800
Phone (631) 775-8203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110103000393 NY Part B Supplier - Clinic/Group Practice 3375731599 Receives reassigned benefits from 1 practitioner
Practice locations: East Yaphank, NY

National Provider Directory

National Provider Directory

Locations

1490 William Floyd Pkwy
Ste 103
East Yaphank, NY 11967
Phone (631) 775-8202

1500 William Floyd Pkwy
Ste 302
Shirley, NY 11967
Phone (516) 622-6100

1500 William Floyd Pkwy
Ste 32
Shirley, NY 11967

213 Hallock Rd
Ste 6
Stony Brook, NY 11790
Phone (631) 689-6858

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1292889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342396800000",
    "number": "1851694483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 WILLIAM FLOYD PKWY",
            "address_2": "SUITE 303",
            "city": "EAST YAPHANK",
            "state": "NY",
            "postal_code": "119671800",
            "telephone_number": "631-775-8203",
            "fax_number": "631-775-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 WILLIAM FLOYD PKWY",
            "address_2": "SUITE 303",
            "city": "EAST YAPHANK",
            "state": "NY",
            "postal_code": "119671800",
            "telephone_number": "631-775-8203",
            "fax_number": "631-775-8202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN LI SPEECH PATHOLOGY &SWALLOWING DISORDERS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-21",
        "last_updated": "2012-07-16",
        "status": "A",
        "authorized_official_last_name": "STIENE",
        "authorized_official_first_name": "JANINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-689-6858",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "011861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Yaphank, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; 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.