Provider Demographics
NPI:1700195617
Name:KAMINETZKY, FAIGY (MASTERS)
Entity Type:Individual
Prefix:
First Name:FAIGY
Middle Name:
Last Name:KAMINETZKY
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1034 VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-4829
Mailing Address - Country:US
Mailing Address - Phone:347-342-8014
Mailing Address - Fax:
Practice Address - Street 1:1034 VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4829
Practice Address - Country:US
Practice Address - Phone:347-342-8014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0151131235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist