Individual provider Active NPI

Nellyzita Offoha-Nwosu

  • Speech-Language Pathologist
  • Cambria Heights, NY
National Provider Identifier
1932393089
Registry record updated Oct 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
013318-1 Issued in NY
Practice address
12023 Springfield Blvd
Cambria Heights, NY 11411-1925
Phone
(315) 383-6524
NPI assigned
Aug 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 013318-1 NY Primary

Addresses

Primary practice location

12023 Springfield Blvd
Cambria Heights, NY 11411-1925

Mailing address

12023 Springfield Blvd
Cambria Heights, NY 11411-1925
Phone (315) 383-6524

Other names 1

  • Nellyzita Nwosu Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100727000641 NY Practitioner - Qualified Speech Language Pathologist 3971636044 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
013318NYMDSports Physician Chiropractor
013318-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MHH Psychology and Speech-Language Pathology Therapy Services PLLC CurrentSince Sep 15, 2018 Accepting new patients
Welllife Network Inc. Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224460800000",
    "number": "1932393089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12023 SPRINGFIELD BLVD",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "114111925",
            "telephone_number": "315-383-6524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12023 SPRINGFIELD BLVD",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "114111925",
            "telephone_number": "315-383-6524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFFOHA-NWOSU",
        "first_name": "NELLYZITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-31",
        "last_updated": "2008-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "013318-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NELLYZITA",
            "last_name": "NWOSU",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cambria Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.