Provider Demographics
NPI:1912227984
Name:KENIGEL, MARINA (MS, SLP/TSSLD)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:KENIGEL
Suffix:
Gender:F
Credentials:MS, SLP/TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2388 OCEAN AVE
Mailing Address - Street 2:#12
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3564
Mailing Address - Country:US
Mailing Address - Phone:917-776-0700
Mailing Address - Fax:
Practice Address - Street 1:2388 OCEAN AVE
Practice Address - Street 2:#12
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3564
Practice Address - Country:US
Practice Address - Phone:917-776-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019929-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist