Provider Demographics
NPI:1003059205
Name:KERNER, AMY LYNN (SLP)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:LYNN
Last Name:KERNER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:KERNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SLP
Mailing Address - Street 1:1410 YORK AVE
Mailing Address - Street 2:APT 4C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3463
Mailing Address - Country:US
Mailing Address - Phone:212-988-4221
Mailing Address - Fax:
Practice Address - Street 1:1410 YORK AVE
Practice Address - Street 2:APT 4C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3463
Practice Address - Country:US
Practice Address - Phone:212-988-4221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011013-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist