Provider Demographics
NPI:1922312313
Name:STREITER KAMIENNY, SARAH M (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:M
Last Name:STREITER KAMIENNY
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 1:14711 76TH AVE
Mailing Address - Street 2:APT 1A
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3154
Mailing Address - Country:US
Mailing Address - Phone:646-330-5463
Mailing Address - Fax:
Practice Address - Street 1:6845 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1305
Practice Address - Country:US
Practice Address - Phone:718-263-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020031235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist