Active NPI
Matthew E Connolly, SLP
- Speech-Language Pathologist
- Huntington Station, NY
National Provider Identifier
1922143379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 01193-1
- Practice address
- 3 Greenhills Rd
Huntington Station, NY 11746-3905 - Phone
- (917) 714-2498
- NPI assigned
- Feb 21, 2007
- Last updated
- Dec 6, 2016
- Sex
- Male
- 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 | 01193-1 | NY | Primary |
Addresses
Primary practice location
3 Greenhills Rd
Huntington Station, NY 11746-3905
Mailing address
29 Nursery Raod
Melville, NY 11747
Phone (917) 714-2498
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 |
|---|---|---|---|
| 01193-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480982400000",
"number": "1922143379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 NURSERY RAOD",
"city": "MELVILLE",
"state": "NY",
"postal_code": "11747",
"telephone_number": "917-714-2498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 GREENHILLS RD",
"city": "HUNTINGTON STATION",
"state": "NY",
"postal_code": "117463905",
"telephone_number": "917-714-2498"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNOLLY",
"first_name": "MATTHEW",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-21",
"last_updated": "2016-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "01193-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington Station, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.