Kaitlyn Rose Agen
Individual provider Active NPI Speech-Language Pathologist · Eden, NY
NPI 1487176152 · NPPES record last updated May 1, 2019
Key facts
- NPI
- 1487176152
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 026812 (NY)
- Practice address
- 2957 Schoolview Road
Eden, NY 14057 - Phone
- (716) 228-3114
- NPI assigned
- Jul 13, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 026812 | NY | Yes |
Addresses
Primary practice location
2957 Schoolview Road
Eden, NY 14057
Mailing address
2957 Schoolview Road
Eden, NY 14057
Phone (716) 228-3114
Other names
- Kaitlyn Stayzer
Other providers in Eden, NY
- Absolut Center for Nursing and Rehabilitation at Eden, LLC
- Elizabeth A Achtyl
- Alisha Alfano
- Arbor Park Health Care Center, Inc
- Kenneth J Armstrong
- Battleworks Inc.
- Carol Ann Boismenu
All providers in Eden, 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 May 1, 2019. 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.