NPIMap

Organization Active NPI

Legendary Therapy

  • Early Intervention Provider Agency
  • Staten Island, NY
National Provider Identifier
1861837288
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
LEGENDARY THERAPY
Practice address
997 Stafford Ave
Staten Island, NY 10309-2109
Phone
(917) 853-1226
Fax
(718) 679-9823
NPI assigned
Apr 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Authorized official

Name
Christine Salomon, MA, OTR/L
Title
Clinical Supervisor
Phone
(917) 853-1226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

997 Stafford Ave
Staten Island, NY 10309-2109

Mailing address

997 Stafford Ave
Staten Island, NY 10309-2109
Phone (917) 853-1226

National Provider Directory

National Provider Directory
Tax ID family
Legendary Speech Pathology PLLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367280000000",
    "number": "1861837288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "997 STAFFORD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103092109",
            "telephone_number": "917-853-1226",
            "fax_number": "718-679-9823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "997 STAFFORD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103092109",
            "telephone_number": "917-853-1226",
            "fax_number": "718-679-9823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGENDARY THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-30",
        "last_updated": "2013-04-30",
        "status": "A",
        "authorized_official_last_name": "SALOMON",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "917-853-1226",
        "authorized_official_credential": "MA, OTR/L"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; 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.