Active NPI
Kristen Michele Spang, MA, SLP, TSSLD
- Speech-Language Pathologist
- Glendale, NY
National Provider Identifier
1922523935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 026923-1
- Practice address
- 79-56 77TH Road
Glendale, NY 11385 - Phone
- (718) 607-2778
- NPI assigned
- Aug 10, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 026923-1 | NY | Primary |
Addresses
Primary practice location
79-56 77TH Road
Glendale, NY 11385
Mailing address
7956 77TH Rd
Glendale, NY 11385-7523
Phone (718) 607-2778
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026923-1 | NY | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1922523935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7956 77TH RD",
"city": "GLENDALE",
"state": "NY",
"postal_code": "113857523",
"telephone_number": "718-607-2778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79-56 77TH ROAD",
"city": "GLENDALE",
"state": "NY",
"postal_code": "11385",
"telephone_number": "718-607-2778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPANG",
"first_name": "KRISTEN",
"middle_name": "MICHELE",
"name_prefix": "Ms.",
"credential": "MA, SLP, TSSLD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-10",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "026923-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.