Individual provider Active NPI

Allison Coppola Melengic, MA CCC-CLP

  • Speech-Language Pathologist
  • West Babylon, NY
National Provider Identifier
1902937543
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
58 017087 Issued in NY
Practice address
529 17TH St
West Babylon, NY 11704-2626
Phone
(631) 226-2645
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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 58 017087 NY Primary

Addresses

Primary practice location

529 17TH St
West Babylon, NY 11704-2626

Mailing address

529 17TH St
West Babylon, NY 11704-2626
Phone (631) 226-2645

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
58 017087NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Center for Speech, Language and Swallowing Disorders, LLP Past Accepting new patients
South Shore Speech Language and Swallowing Disorders PLLC Speech-Language Pathologist PastSince Oct 12, 2009 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1902937543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 17TH ST",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117042626",
            "telephone_number": "631-226-2645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 17TH ST",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117042626",
            "telephone_number": "631-226-2645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPOLA MELENGIC",
        "first_name": "ALLISON",
        "credential": "MA CCC-CLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "58 017087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Babylon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; 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.