Individual provider Active NPI

Bonnie S Egan, MS CCC/SLP

  • Speech-Language Pathologist
  • New York, NY
National Provider Identifier
1861647141
Registry record updated Nov 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1039 Issued in NY
Practice address
60 E 96TH St
Apartment 13E
New York, NY 10128-0757
Phone
(212) 427-0809
NPI assigned
Nov 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1039 NY Primary

Addresses

Primary practice location

60 E 96TH St
Apartment 13E
New York, NY 10128-0757

Mailing address

60 E 96TH St
Apartment 13E
New York, NY 10128-0757
Phone (212) 427-0809

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1039NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1228003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228003200000",
    "number": "1861647141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 E 96TH ST",
            "address_2": "APARTMENT 13E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101280757",
            "telephone_number": "212-427-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 E 96TH ST",
            "address_2": "APARTMENT 13E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101280757",
            "telephone_number": "212-427-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGAN",
        "first_name": "BONNIE",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "MS CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-30",
        "last_updated": "2008-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "1039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2008; 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.