Provider Demographics
NPI:1871648956
Name:KORNSWEIG, CAROLE LINDA (MA CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:CAROLE
Middle Name:LINDA
Last Name:KORNSWEIG
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:MISS
Other - First Name:CAROLE
Other - Middle Name:LINDA
Other - Last Name:GRUNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:29 GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-1232
Mailing Address - Country:US
Mailing Address - Phone:516-524-0450
Mailing Address - Fax:516-791-8631
Practice Address - Street 1:71 S CENTRAL AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-5495
Practice Address - Country:US
Practice Address - Phone:516-524-0450
Practice Address - Fax:516-791-8631
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY849235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AS1681OtherOXFORD INSURANCE
0000057740501OtherUNITED HEALTHCARE