IndividualActive
Ijalu Fernandez, MA,CCC-SLP
NPI 1104060052 · Speech-Language Pathologist · Brooklyn, NY
Provider details
- NPI number
- 1104060052
- Entity type
- Individual
- Primary specialty
- Speech-Language PathologistSpeech, Language and Hearing Service Providers
- Credential
- MA,CCC-SLP
- Sex
- Female
- Sole proprietor
- Yes
- License
- 0164511 (NY)
Specialties & taxonomies
Speech, Language and Hearing Service Providers
Profile Score
Detailed profile(85/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
200 Woodbine St
Brooklyn, NY 11221-4748
Phone: (347) 684-7455
Approximate (ZIP-level) locationGet directions
Mailing address
14306 Sutter Ave
South Ozone Park, NY 11436-1800
Registry dates
- Enumerated
- 2009-04-22
- Last updated
- 2016-12-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.