NPIMap

Organization Active NPI

Expression Connection LLC

  • Speech-Language Pathologist
  • Brooklyn, NY
National Provider Identifier
1871127746
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
EXPRESSION CONNECTION LLC
Practice address
376 Keap St Apt 63
Brooklyn, NY 11211-6363
Phone
(347) 658-3858
NPI assigned
Feb 28, 2020
Last updated
Feb 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Authorized official

Name
Evelyn C Custodio, CCC-SLPNPI 1740678564
Title
Speech-Language Pathologist
Phone
(929) 414-1234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

376 Keap St Apt 63
Brooklyn, NY 11211-6363

Mailing address

376 Keap St Apt 63
Brooklyn, NY 11211-6363
Phone (347) 658-3858

Other identifiers 1

IdentifierTypeStateIssuer
04574705MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL N/A Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1582848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582848000000",
    "number": "1871127746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 KEAP ST APT 63",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112116363",
            "telephone_number": "347-658-3858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 KEAP ST APT 63",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112116363",
            "telephone_number": "347-658-3858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESSION CONNECTION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-28",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A",
        "authorized_official_last_name": "CUSTODIO",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "929-414-1234",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04574705",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "376 Keap St Apt 63",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112116363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; 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.