Kimberlee Bauman

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

NPI 1942744487 · NPPES record last updated Dec 16, 2016

Key facts

NPI
1942744487
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
106213 (NY)
Practice address
7823 87TH St
Glendale, NY 11385-7655
Phone
(718) 847-0724
Fax
(718) 805-0737
NPI assigned
Dec 16, 2016
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)
No

State licenses

LicenseStateTypeSpecialty
106213NYMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 106213 NY Yes

Addresses

Primary practice location

7823 87TH St
Glendale, NY 11385-7655

Mailing address

7823 87TH St
New York, Ny 11385
Glendale, NY 11385
Phone (718) 847-0724

Other providers in Glendale, NY

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

Sources for this page

Verify at the official NPI Registry.