Active NPI
Dominique Gesualdi
- Speech-Language Pathologist
- New Canaan, CT
National Provider Identifier
1952185415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4699
- Practice address
- 62 Main St
New Canaan, CT 06840-4748 - Phone
- (914) 907-7437
- NPI assigned
- Aug 24, 2023
- 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 | 4699 | CT | Primary |
Addresses
Primary practice location
62 Main St
New Canaan, CT 06840-4748
Mailing address
62 Main St
New Canaan, CT 06840-4748
Phone (914) 907-7437
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4699 | CT | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692835200000",
"number": "1952185415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 MAIN ST",
"city": "NEW CANAAN",
"state": "CT",
"postal_code": "068404748",
"telephone_number": "914-907-7437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 MAIN ST",
"city": "NEW CANAAN",
"state": "CT",
"postal_code": "068404748",
"telephone_number": "914-907-7437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GESUALDI",
"first_name": "DOMINIQUE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-24",
"last_updated": "2023-08-24",
"certification_date": "2023-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CT",
"license": "4699",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Canaan, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.