Mary Boghosian, M.A.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

008482-1 Issued in NY

Practice address

400 W Main St
Babylon, NY 11702-3012

Phone

(631) 669-7098

Fax

(631) 669-3736

NPI assigned

Feb 6, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Shore Speech Language and Swallowing Disorders PLLC

  • Speech-Language Pathologist
  • Babylon, NY
  • NPI 1568798619
  Medicare reassignment
• South Shore Center for Speech, Language and Swallowing Disorders, LLP

  • Early Intervention Provider Agency
  • Babylon, NY
  • NPI 1255579785
  NPD (past)

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962541649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 BARDOLIER LN",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067601",
            "telephone_number": "631-665-9168",
            "fax_number": "631-665-9179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W MAIN ST",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117023012",
            "telephone_number": "631-669-7098",
            "fax_number": "631-669-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGHOSIAN",
        "first_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "008482-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Bjelland, MSW
• Sophia-Jo Blauvelt
• Bloom Flourish Mental Health Counseling, PLLC
• Blumenthal and Rogers DDS, PC
• Suchitha Bodapati, M.D
• Christine Bonczek, P.T.
• Diane Botto
• Elaine Bouras
• James Ernest Bozinos, PSY.D.
• Brian V. Becker M.a.P.T.PLLC (Excel Rehabilitation and Sports Therapy)

• Speech-Language Pathologist in Babylon, NY
• Providers in Babylon, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.