Provider Demographics
NPI:1790240091
Name:KARNIS, MEREDITH (MS CCC-SLP, TSSLD)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:KARNIS
Suffix:
Gender:F
Credentials:MS CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 ADELPHI ST APT 11
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-3313
Mailing Address - Country:US
Mailing Address - Phone:718-288-9541
Mailing Address - Fax:
Practice Address - Street 1:272 MACDONOUGH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-1007
Practice Address - Country:US
Practice Address - Phone:718-388-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028434235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY235Z00000XMedicaid