Kimberly Mora, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

031521-01 Issued in NY

Practice address

1200 Montauk Hwy
Oakdale, NY 11769-1540

Phone

(631) 567-4901

NPI assigned

Mar 13, 2022

Last updated

Mar 13, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1647129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647129600000",
    "number": "1902554603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 CONNECTICUT AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631715",
            "telephone_number": "631-830-9275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MONTAUK HWY",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691540",
            "telephone_number": "631-567-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA",
        "first_name": "KIMBERLY",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-13",
        "last_updated": "2022-03-13",
        "certification_date": "2022-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "031521-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barry Mildener, MD
• Alexandra Nicole Miller, LCSW
• Mind and Body Wellness
• Pamela Lauren Mitchell, PH.D.
• Michael C Moore, PTA
• Stephanie Moreau
• Jacqueline Morgan
• Barri Jessica Morrison, DVM
• Joseph E Mottola
• Bishnu Munaswar

• Speech-Language Pathologist in Oakdale, NY
• Providers in Oakdale, 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 Mar 13, 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.