Provider Demographics
NPI:1124390166
Name:KUCHMEISTER, NICOLE PAOLILLO
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:PAOLILLO
Last Name:KUCHMEISTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17837 146TH TER
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-5330
Mailing Address - Country:US
Mailing Address - Phone:718-528-2238
Mailing Address - Fax:
Practice Address - Street 1:17837 146TH TER
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434
Practice Address - Country:US
Practice Address - Phone:718-528-2238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-07
Last Update Date:2018-07-18
Deactivation Date:2013-09-27
Deactivation Code:
Reactivation Date:2016-12-20
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist