Blue Horizon Speech-Language Pathology PC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

BLUE HORIZON SPEECH-LANGUAGE PATHOLOGY PC

Practice address

402 Donald Blvd
Holbrook, NY 11741-3942

Phone

(631) 235-6388

NPI assigned

Dec 3, 2019

Last updated

Dec 3, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Katelyn Prestigiacomo, MS CCC SLP

Title

President

Phone

(631) 235-6388

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1575331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575331200000",
    "number": "1902443427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 DONALD BLVD",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117413942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 DONALD BLVD",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117413942",
            "telephone_number": "631-235-6388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE HORIZON SPEECH-LANGUAGE PATHOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-03",
        "last_updated": "2019-12-03",
        "status": "A",
        "authorized_official_last_name": "PRESTIGIACOMO",
        "authorized_official_first_name": "KATELYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-235-6388",
        "authorized_official_credential": "MS CCC SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS",
            "identifier": "025137",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carly Bertolino
• Diane Sanchez Bianco, LCSW
• Barbara Bitzer, PT
• Donna Lynn Blank
• Melissa Blom, LMT
• Kaylie Bodvake
• Christopher Borak, BCBA
• Leann Bonnie Borneman, LCSW
• Michael J Boruchov, D.D.S.
• Bracetown Holbrook Orthodontics. LLP

• Speech-Language Pathologist in Holbrook, NY
• Providers in Holbrook, 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 Dec 3, 2019; 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.