EDJAE VILLAMOR SIRIBAN MA, CCC-SLP
NPI 1316678782
Speech-Language Pathologist in New York, NY

Active since June 17, 2022
1901 1ST AVE, NEW YORK, NY 10029(212) 423-6262 Get Directions Write a Review

NPPES record last updated: April 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Edjae Villamor Siriban Ma, Ccc-slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDJAE VILLAMOR SIRIBAN MA, CCC-SLP (NPI 1316678782) is an individual speech-language pathologist provider in New York, New York and active in the NPI registry since June 2022. She maintains a secondary practice location in Fort Lee and is a graduate of Other (2020).

NPPES Registry Identity

NPI1316678782
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameEDJAE VILLAMOR SIRIBANCredential: MA, CCC-SLP
Location Address1901 1ST AVENew York, NY 10029-7494
Mailing Address1315 Anderson Ave Apt 23Fort Lee, NJ 07024-1732
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJune 17, 2022
Last NPPES UpdateApril 11, 2025
NPPES CertifiedApril 11, 2025
NPI 1316678782 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
1901 1ST AVE, New York, NY 10029

Secondary Practice Location 1

Location 1100 Central Ave Apt 5BFort Lee, NJ 07024-7311 · Phone (973) 534-8796

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Edjae Villamor Siriban Ma, Ccc-slp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8820500069
PECOS Enrollment IDI20250624002509

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
1901 1ST AVE
NEW YORK, NY 10029
Pharmacist (Pharmacotherapy)
1901 1ST AVE
NEW YORK, NY 10029
Emergency Medicine
1901 1ST AVE
NEW YORK, NY 10029
Student in an Organized Health Care Education/Training Program
1901 1ST AVE
NEW YORK, NY 10029
Psychiatry & Neurology (Psychiatry)
1901 1ST AVE
NEW YORK, NY 10029
Student in an Organized Health Care Education/Training Program
1901 1ST AVE
NEW YORK, NY 10029
Social Worker (Clinical)
1901 1ST AVE
NEW YORK, NY 10029
Internal Medicine (Critical Care Medicine)
1901 1ST AVE
NEW YORK, NY 10029

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edjae Siriban's NPI number?

The NPI number for Edjae Siriban is 1316678782. It was assigned to this individual provider in the NPPES registry on June 17, 2022.

Where is Edjae Siriban located?

Edjae Siriban practices at 1901 1st Ave, New York, NY 10029. The listed phone number is (212) 423-6262.

What is Edjae Siriban's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Edjae Siriban enrolled in Medicare?

Yes. Edjae Siriban is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Edjae Siriban was last updated on April 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.