New York Speech and Language PLLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

NEW YORK SPEECH AND LANGUAGE PLLC

Practice address

4505 Broadway
Astoria, NY 11103-1625

Phone

(302) 841-7685

NPI assigned

Jan 22, 2019

Last updated

Jan 22, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jordan Wills, M.S. CCC-SLPNPI 1720528847

Title

Partner, SLP

Phone

(302) 841-7685

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jordan Wills

  • Speech-Language Pathologist
  • Astoria, NY
  • NPI 1720528847
  NPD Authorized official

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548115200000",
    "number": "1952865131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 BROADWAY",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111031625",
            "telephone_number": "302-841-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 BROADWAY",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111031625",
            "telephone_number": "302-841-7685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK SPEECH AND LANGUAGE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-22",
        "last_updated": "2019-01-22",
        "status": "A",
        "authorized_official_last_name": "WILLS",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "PARTNER, SLP",
        "authorized_official_telephone_number": "302-841-7685",
        "authorized_official_credential": "M.S. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05081663",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Astoria, NY
• Providers in Astoria, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.