Individual provider Active NPI

Denise M Sivaslian, MA, CCC-SLP

  • Speech-Language Pathologist
  • Sayville, NY
National Provider Identifier
1881932044
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
016167-1 Issued in NY
Practice address
41 Lucille Dr
Sayville, NY 11782-1518
Phone
(631) 921-9375
NPI assigned
Jan 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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 016167-1 NY Primary

Addresses

Primary practice location

41 Lucille Dr
Sayville, NY 11782-1518

Mailing address

41 Lucille Dr
Sayville, NY 11782-1518
Phone (631) 921-9375

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 Arts

State licenses

LicenseStateTypeSpecialty
016167-1NYMDSpeech-Language Pathologist

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1881932044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 LUCILLE DR",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117821518",
            "telephone_number": "631-921-9375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 LUCILLE DR",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117821518",
            "telephone_number": "631-921-9375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVASLIAN",
        "first_name": "DENISE",
        "middle_name": "M",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-23",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "016167-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sayville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.