NPI Code Detail JSON Logo

1811207921 NPI number — LAURA KATERYNA MCNICHOLAS M.A. CCC-SLP, TSSLD

NPI Number: 1811207921
Health Care Provider/Practitioner: LAURA KATERYNA MCNICHOLAS M.A. CCC-SLP, TSSLD

Information about “1811207921” NPI (LAURA KATERYNA MCNICHOLAS M.A. CCC-SLP, TSSLD) exists in 1811207921 in HTML format HTML  |  1811207921 in plain Text format TXT  |  1811207921 in PDF (Portable Document Format) PDF  |  1811207921 in an XML format XML  formats.

NPI Number : 1811207921 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1811207921",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MCNICHOLAS",
    "FirstName": "LAURA",
    "MiddleName": "KATERYNA",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "M.A. CCC-SLP, TSSLD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SEMKOW",
    "OtherFirstName": "LAURA",
    "OtherMiddleName": "KATERYNA",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": "M.A. CCC-SLP, TSSLD",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "91 STRAWBERRY HILL AVE",
    "SecondLineMailingAddress": "APT 428",
    "MailingAddressCityName": "STAMFORD",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06902-2762",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "203-569-0050",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5 BRADHURST AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HAWTHORNE",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "10532-2135",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "914-592-8526",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/08/2010",
    "LastUpdateDate": "01/07/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "235Z00000X",
        "TaxonomyName": "Speech-Language Pathologist",
        "LicenseNumber": "019209-1",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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