Provider Demographics
NPI:1952854374
Name:SITI, KATHRYN CHRISTINE (MS)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:CHRISTINE
Last Name:SITI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 GRAND ST
Mailing Address - Street 2:APT M103
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-3905
Mailing Address - Country:US
Mailing Address - Phone:908-619-2848
Mailing Address - Fax:
Practice Address - Street 1:383 GRAND ST
Practice Address - Street 2:APT M103
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-3905
Practice Address - Country:US
Practice Address - Phone:908-619-2848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1041515161235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist