Jeanne Kiernan, SLP
Individual provider Active NPI Speech-Language Pathologist · Southold, NY
NPI 1104135524 · NPPES record last updated Oct 4, 2010
Key facts
- NPI
- 1104135524
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 017908 (NY)
- Practice address
- 1600 Gin LN
Southold, NY 11971-4236 - Phone
- (631) 765-8589
- NPI assigned
- Oct 4, 2010
- Sex
- Female
- Sole proprietor
- Yes
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 017908 | NY | Yes |
Addresses
Primary practice location
1600 Gin LN
Southold, NY 11971-4236
Mailing address
1600 Gin LN
Southold, NY 11971-4236
Other providers in Southold, NY
- Peter Kevin Johnstone Jr.
- Nicholas Kardaras
- Harriette Keely
- Noreen Bawn Kelly
- Casey Kerbs
- Irene Kontoleon
- Anna Kozlowska
- Robert T Kroepel
- Kathryn Krukowski
- William Lappe
All providers in Southold, NY · Speech-Language Pathologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.