Bidico Speech Language Pathologist, PLLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

015479 Issued in NY

Legal business name

BIDICO SPEECH LANGUAGE PATHOLOGIST, PLLC

Practice address

11701 Park LN S Apt D3F
Richmond Hill, NY 11418-1052

Phone

(646) 326-1633

NPI assigned

Oct 25, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Laura Costa, MS/SLP

Title

Member

Phone

(646) 326-1633

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1445731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445731200000",
    "number": "1992177315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11701 PARK LN S APT D3F",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114181052",
            "telephone_number": "646-326-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11701 PARK LN S APT D3F",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114181052",
            "telephone_number": "646-326-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIDICO SPEECH LANGUAGE PATHOLOGIST, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-25",
        "last_updated": "2015-10-25",
        "status": "A",
        "authorized_official_last_name": "COSTA",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "646-326-1633",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS/SLP"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "015479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03789833",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Early Intervention Provider Agency in Richmond Hill, NY
• Providers in Richmond Hill, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2015; 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.