Provider Demographics
NPI:1831633767
Name:KAMIN, ALLAN (SPEECH PATHOLOGIST)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:
Last Name:KAMIN
Suffix:
Gender:M
Credentials:SPEECH PATHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 KINGSTON AVE
Mailing Address - Street 2:APT 53
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-4333
Mailing Address - Country:US
Mailing Address - Phone:347-633-4074
Mailing Address - Fax:
Practice Address - Street 1:383 KINGSTON AVE
Practice Address - Street 2:APT 53
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-4333
Practice Address - Country:US
Practice Address - Phone:347-633-4074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01224-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist