Individual provider Active NPI

Janice Ann Eaton, M.A.CCC-SLP

  • Speech-Language Pathologist
  • Massapequa Park, NY
National Provider Identifier
1932418910
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
010628-1 Issued in NY
Practice address
174 Lindbergh St
Massapequa Park, NY 11762-2236
Phone
(516) 797-9494
Fax
(516) 797-0008
NPI assigned
Sep 24, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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 010628-1 NY Primary

Addresses

Primary practice location

174 Lindbergh St
Massapequa Park, NY 11762-2236

Mailing address

174 Lindbergh St
Massapequa Park, NY 11762-2236
Phone (516) 220-0715

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

State licenses

LicenseStateTypeSpecialty
010628-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1285286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1932418910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 LINDBERGH ST",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117622236",
            "telephone_number": "516-220-0715",
            "fax_number": "516-726-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 LINDBERGH ST",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117622236",
            "telephone_number": "516-797-9494",
            "fax_number": "516-797-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "JANICE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.A.CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-24",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "010628-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.