Individual provider Active NPI

Marla Elayna Panciocco D'Alfonso

  • Speech-Language Pathologist
  • Providence, RI
National Provider Identifier
1982076212
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP01358 Issued in RI
Practice address
68 Erie St
Providence, RI 02908-1220
Phone
(339) 237-0290
NPI assigned
Oct 26, 2015
Last updated
Apr 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 31905 CA
Speech-Language Pathologist 235Z00000X 9637 MA
Speech-Language Pathologist 235Z00000X SP01358 RI Primary

Addresses

Primary practice location

68 Erie St
Providence, RI 02908-1220

Mailing address

68 Erie St
Providence, RI 02908-1220
Phone (339) 237-0290

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

LicenseStateTypeSpecialty
31905CAMDClinical Psychologist
9637MAMDSpeech-Language Pathologist
SP01358RIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1982076212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 ERIE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029081220",
            "telephone_number": "339-237-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 ERIE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029081220",
            "telephone_number": "339-237-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ALFONSO",
        "first_name": "MARLA",
        "middle_name": "ELAYNA PANCIOCCO",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-26",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "31905",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "9637",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "RI",
            "license": "SP01358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; 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.