Active NPI
Tiffany Wickert
- Speech-Language Pathologist
- Warren, NJ
National Provider Identifier
1922643089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 032797
- Practice address
- 67A Mountain Blvd Ext.
1St Floor, Unit B
Warren, NJ 07059-5626 - Phone
- (908) 873-6337
- Fax
- (908) 332-5668
- NPI assigned
- Nov 13, 2019
- 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 | 032797 | NY | Primary |
Addresses
Primary practice location
67A Mountain Blvd Ext.
1St Floor, Unit B
Warren, NJ 07059-5626
Mailing address
19 Dartmouth Dr
Hazlet, NJ 07730-2322
Phone (347) 552-2371
Other practice location 1
1854 Hylan Blvd Ste 2
Staten Island, NY 10305-2119
Phone (347) 552-2371
Other practice location 2
151 Woodbine Ave
Staten Island, NY 10314-1833
Phone (347) 552-2371
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cortica New Jersey Developmental Therapies, PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Developmental Disabilities Clinic/Center
- Warren, NJ
- NPI 1104589365
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694736000000",
"number": "1922643089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 DARTMOUTH DR",
"city": "HAZLET",
"state": "NJ",
"postal_code": "077302322",
"telephone_number": "347-552-2371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67A MOUNTAIN BLVD EXT.",
"address_2": "1ST FLOOR, UNIT B",
"city": "WARREN",
"state": "NJ",
"postal_code": "070595626",
"telephone_number": "908-873-6337",
"fax_number": "908-332-5668"
}
],
"practiceLocations": [
{
"address_1": "1854 Hylan Blvd Ste 2",
"address_purpose": "LOCATION",
"city": "Staten Island",
"state": "NY",
"postal_code": "103052119",
"country_code": "US",
"telephone_number": "347-552-2371",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "151 Woodbine Ave",
"address_purpose": "LOCATION",
"city": "Staten Island",
"state": "NY",
"postal_code": "103141833",
"country_code": "US",
"telephone_number": "347-552-2371",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WICKERT",
"first_name": "TIFFANY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-13",
"last_updated": "2023-09-15",
"certification_date": "2023-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "032797",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warren, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.