Active NPI
Melissa P Kreuder, CCC-SLP
- Speech-Language Pathologist
- West Islip, NY
National Provider Identifier
1912213455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 013774-1
- Practice address
- 420 Oak Neck Rd
West Islip, NY 11795-3614 - Phone
- (631) 422-2046
- NPI assigned
- Aug 22, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 013774-1 | NY | Primary |
Addresses
Primary practice location
420 Oak Neck Rd
West Islip, NY 11795-3614
Mailing address
420 Oak Neck Rd
West Islip, NY 11795-3614
Phone (631) 422-2046
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013774-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282435200000",
"number": "1912213455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 OAK NECK RD",
"city": "WEST ISLIP",
"state": "NY",
"postal_code": "117953614",
"telephone_number": "631-422-2046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 OAK NECK RD",
"city": "WEST ISLIP",
"state": "NY",
"postal_code": "117953614",
"telephone_number": "631-422-2046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KREUDER",
"first_name": "MELISSA",
"middle_name": "P",
"name_prefix": "Mrs.",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-22",
"last_updated": "2010-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "013774-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Islip, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.