Active NPI
Tara Boszczuk, MS, CF-SLP
- Speech-Language Pathologist
- Virginia Beach, VA
National Provider Identifier
1962076794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7419
- Practice address
- 5604 Virginia Beach Blvd Ste 101
Virginia Beach, VA 23462-5631 - Phone
- (757) 455-5000
- NPI assigned
- May 17, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 7419 | SC | Primary |
Addresses
Primary practice location
5604 Virginia Beach Blvd Ste 101
Virginia Beach, VA 23462-5631
Mailing address
31 Birdie Way
Lawrence Township, NJ 08648-2721
Phone (908) 455-0853
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7419 | SC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626998400000",
"number": "1962076794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 BIRDIE WAY",
"city": "LAWRENCE TOWNSHIP",
"state": "NJ",
"postal_code": "086482721",
"telephone_number": "908-455-0853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5604 VIRGINIA BEACH BLVD STE 101",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234625631",
"telephone_number": "757-455-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSZCZUK",
"first_name": "TARA",
"credential": "MS, CF-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-17",
"last_updated": "2021-07-23",
"certification_date": "2021-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "SC",
"license": "7419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.