Jacqulynn Miden, M.S. CCC,SLP- TSSLD

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

0283141 Issued in NY

Practice address

10104 158TH Ave
Howard Beach, NY 11414-3212

Phone

(917) 991-0287

NPI assigned

Jan 15, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Jacqulynn Luciano Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1902370612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10104 158TH AVE",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114143212",
            "telephone_number": "917-991-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10104 158TH AVE",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114143212",
            "telephone_number": "917-991-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDEN",
        "first_name": "JACQULYNN",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC,SLP- TSSLD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-15",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "0283141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQULYNN",
            "last_name": "LUCIANO",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert Melo, D.C.
• Schandel Ann Meshman, T.S.H.H, MSED
• Jaime Messineo-Figueroa, M.S
• Rebecca M Meyer
• Michael Bernfeld D.D.S Yakov Kurilenko D.D.S P.C.
• James Milidantri, DPM
• Theresa Valentini Miller, LCSW
• Miriam Milord
• Victoria Mirzokandova
• Marc Mishan, O.D.

• Speech-Language Pathologist in Howard Beach, NY
• Providers in Howard Beach, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.