Provider Demographics
NPI:1356629141
Name:KOHN, MIRIAM (MA)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:KOHN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 DYKSTRAS WAY E
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-4023
Mailing Address - Country:US
Mailing Address - Phone:845-517-0072
Mailing Address - Fax:
Practice Address - Street 1:45 DYKSTRAS WAY E
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-4023
Practice Address - Country:US
Practice Address - Phone:845-517-0072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021001-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist