Provider Demographics
NPI:1942622352
Name:HORNUNG, KIMBERLY LYNN (MS, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:LYNN
Last Name:HORNUNG
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:MRS
Other - First Name:KIMBERLY
Other - Middle Name:LYNN
Other - Last Name:BARNETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS CCC/SLP
Mailing Address - Street 1:2 LARCH AVENUE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001
Mailing Address - Country:US
Mailing Address - Phone:516-327-9300
Mailing Address - Fax:
Practice Address - Street 1:10 ELIZABETH ST
Practice Address - Street 2:JOHN LEWIS CHILDS ELEMENTARY SCHOOL
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001
Practice Address - Country:US
Practice Address - Phone:516-327-9317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-21
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011164-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist