Provider Demographics
NPI:1508991175
Name:KANE, ANNMARIE (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ANNMARIE
Middle Name:
Last Name:KANE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 JOMAR RD
Mailing Address - Street 2:
Mailing Address - City:SHOREHAM
Mailing Address - State:NY
Mailing Address - Zip Code:11786-1936
Mailing Address - Country:US
Mailing Address - Phone:631-849-4022
Mailing Address - Fax:
Practice Address - Street 1:24 JOMAR RD
Practice Address - Street 2:
Practice Address - City:SHOREHAM
Practice Address - State:NY
Practice Address - Zip Code:11786-1936
Practice Address - Country:US
Practice Address - Phone:631-849-4022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016352-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist