Kevin J Louser, MASLP

Individual provider Active NPI Speech-Language Pathologist · Shoreham, NY

NPI 1003852377 · NPPES record last updated Sep 12, 2008

Key facts

NPI
1003852377
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
014885 (NY)
Practice address
51 Cobblestone Dr
Shoreham, NY 11786-2351
Phone
(631) 335-6381
Fax
(631) 744-4191
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 014885 NY Yes

Addresses

Primary practice location

51 Cobblestone Dr
Shoreham, NY 11786-2351

Mailing address

51 Cobblestone Dr
Shoreham, NY 11786-2351
Phone (631) 744-4191

Other identifiers

IdentifierTypeStateIssuer
014885OtherNYNYS LISCENCE

Other providers in Shoreham, NY

All providers in Shoreham, NY · Speech-Language Pathologist in New York

Sources for this page

Verify at the official NPI Registry.