Individual provider Active NPI

Theresa C Manscuk, MA

  • Speech-Language Pathologist
  • Rochester, NY
National Provider Identifier
1982906830
Registry record updated Nov 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3913-1 Issued in NY
Practice address
194 Field St
Rochester, NY 14620-1942
Phone
(585) 271-4583
Fax
(585) 935-7435
NPI assigned
Nov 29, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3913-1 NY Primary

Addresses

Primary practice location

194 Field St
Rochester, NY 14620-1942

Mailing address

95 Paula Red LN
Rochester, NY 14626-4423
Phone (585) 453-0048

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3913-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1290988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290988800000",
    "number": "1982906830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 PAULA RED LN",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264423",
            "telephone_number": "585-453-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 FIELD ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146201942",
            "telephone_number": "585-271-4583",
            "fax_number": "585-935-7435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSCUK",
        "first_name": "THERESA",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-29",
        "last_updated": "2010-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "3913-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2010; 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.