Active NPI
Elyse Koltowich, CCC-SLP
- Speech-Language Pathologist
- Carmel, NY
National Provider Identifier
1851765630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 034484-01
- Practice address
- 47 Colonel Enoch Dr
Carmel, NY 10512-4304 - Phone
- (646) 302-3341
- NPI assigned
- Nov 17, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 034484-01 | NY | Primary |
Addresses
Primary practice location
47 Colonel Enoch Dr
Carmel, NY 10512-4304
Mailing address
47 Colonel Enoch Dr
Carmel, NY 10512-4304
Phone (646) 302-3341
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 034484-01 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726531200000",
"number": "1851765630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 COLONEL ENOCH DR",
"city": "CARMEL",
"state": "NY",
"postal_code": "105124304",
"telephone_number": "646-302-3341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47 COLONEL ENOCH DR",
"city": "CARMEL",
"state": "NY",
"postal_code": "105124304",
"telephone_number": "646-302-3341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLTOWICH",
"first_name": "ELYSE",
"name_prefix": "Ms.",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-11-17",
"last_updated": "2024-09-17",
"certification_date": "2024-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "034484-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carmel, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.