Buckley-Johnson Pediatrictherapies SLP, PC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

TF1774150 Issued in NY

Legal business name

BUCKLEY-JOHNSON PEDIATRICTHERAPIES SLP, PC

Practice address

117 Harbor LN
Massapequa Park, NY 11762-4057

Phone

(516) 798-2880

Fax

(516) 798-2887

NPI assigned

Jan 24, 2007

Organization subpart

No

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

Authorized official

Name

Mindy Bitterman Buckley, MA, CCC-SLP

Title

Co-Owner

Phone

(516) 798-2880

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962557348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 HARBOR LN",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117624057",
            "telephone_number": "516-798-2880",
            "fax_number": "516-798-2887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 HARBOR LN",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117624057",
            "telephone_number": "516-798-2880",
            "fax_number": "516-798-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKLEY-JOHNSON PEDIATRICTHERAPIES SLP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUCKLEY",
        "authorized_official_first_name": "MINDY",
        "authorized_official_middle_name": "BITTERMAN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "516-798-2880",
        "authorized_official_credential": "MA, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NY",
            "license": "TF1774150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvonne Theresa Bristow, RN/GNP
• Nicole Brock
• Erica Lori Brown, MS, ED.
• Carli Brust
• Alessandra Bruzzese, MSN RN, AGPCNP-C
• Mindy Buckley, M.A., CCC-SLP, TSHH
• Shane Burke, FNP-BC
• Erika Calcagno
• Laura Camera
• Gabriella L Caputo, MA, CCC-SLP, TSSLD

• Developmentally Disabled Services Day Training Agency in Massapequa Park, NY
• Providers in Massapequa Park, NY by specialty
• Developmentally Disabled Services Day Training Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.