Basic Information
| Provider Information | |||||||||
| NPI: | 1528649795 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SLUYK | ||||||||
| FirstName: | KAITLYN | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | M.A. SLP-CFY, TSSLD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 147 BEACH 145TH ST | ||||||||
| Address2: | |||||||||
| City: | NEPONSIT | ||||||||
| State: | NY | ||||||||
| PostalCode: | 116941143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3473068339 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1651 CONEY ISLAND AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112305849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189981415 | ||||||||
| FaxNumber: | 7186720040 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2021 | ||||||||
| LastUpdateDate: | 04/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | NY | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.