Kimberly Patricia Rosalia

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

030960

Practice address

12 Platinum CT
Medford, NY 11763-2247

Phone

(631) 868-3577

NPI assigned

Aug 18, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1922610286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 BARRIE AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117931746",
            "telephone_number": "516-736-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 PLATINUM CT",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632247",
            "telephone_number": "631-868-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSALIA",
        "first_name": "KIMBERLY",
        "middle_name": "PATRICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "030960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Damaris Rodriguez, LCSW
• Gabriel Esteban Rodriguez, RPH
• Deborah Sue Roenbeck, RN
• Eileen Leary Roggemann
• Nichole Romeo
• Leslie A Rosario, RN
• Joan Irene Roseman, R.N.
• Craig S. Rubenstein, DC
• Gail Rudy-Giannino
• Giuseppina M Russo, OD

• Speech-Language Pathologist in Medford, NY
• Providers in Medford, 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 Aug 31, 2021; 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.