Colleen Elizabeth Bova, MA CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS00865200 Issued in NJ

Practice address

110 Jefferson Ave
Emerson, NJ 07630-1233

Phone

(201) 873-3029

NPI assigned

Mar 24, 2021

Last updated

Mar 24, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fox Rehabilitation Services IncGroup PAC ID 0143133009, 1,169 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fox Rehabilitation Services Inc

  • Physical Therapist
  • Wilmington, DE
  • NPI 1326092503

  NJ, Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1891372116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 JEFFERSON AVE",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301233",
            "telephone_number": "201-873-3029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 JEFFERSON AVE",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301233",
            "telephone_number": "201-873-3029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVA",
        "first_name": "COLLEEN",
        "middle_name": "ELIZABETH",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00865200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bergen Women OB GYN Assoc
• Nalini Bethala, MD
• Vivian K Bethala, MD
• Bhavik Mukesh Bhandari, M.D.
• Nedelina Biokua, APN
• Bradley D Geller M D P a
• Tammy Bray, MSRD CDN
• Brea Emeritus (Brookdale Emerson)
• Brea Emerson, LLC (Brookdale Emerson)
• Karen Breidenbach, RPH

• Speech-Language Pathologist in Emerson, NJ
• Providers in Emerson, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.