Khadejar T Dimson, MS,CCC-SLP

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

015579-1 Issued in NY

Practice address

512 Carroll St
Brooklyn, NY 11215-1030

Phone

(718) 624-5271

NPI assigned

Jul 9, 2010

Last updated

Jul 9, 2010By the provider in NPPES

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

Other names 1

• Ms. Khadejar T Addo Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1932411790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 LENOX RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032519",
            "telephone_number": "917-297-4287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 CARROLL ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112151030",
            "telephone_number": "718-624-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMSON",
        "first_name": "KHADEJAR",
        "middle_name": "T",
        "name_prefix": "Ms.",
        "credential": "MS,CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NY",
            "license": "015579-1",
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "015579-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KHADEJAR",
            "last_name": "ADDO",
            "middle_name": "T",
            "prefix": "MS.",
            "credential": "MS, CCC-SLP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sianna Dimitrova
• Dimitry Rabkin, M.D., P.C.
• Dimla Physical Therapy PLLC
• Joanna Dimola, TSSLD
• Olga Christine Dimopoulos
• Holly Maire Dimura, PA-C
• Iftikhar Ud Din, MD
• Shaun Ud Din, M.D.
• Tayyeb Din, PHARMD
• Dina Israelov Midwifery PC

• Early Intervention Provider Agency in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.