Provider Demographics
NPI:1346425246
Name:NIZOLEK, KARA (SLP)
Entity type:Individual
Prefix:MS
First Name:KARA
Middle Name:
Last Name:NIZOLEK
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 3RD AVE
Mailing Address - Street 2:LUTHERAN MEDICAL CENTER-MANAGED CARE DEPARTMENT
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-3702
Mailing Address - Country:US
Mailing Address - Phone:718-630-7477
Mailing Address - Fax:718-630-7437
Practice Address - Street 1:320 60TH ST
Practice Address - Street 2:LUTHERAN MEDICAL CENTER-CENTER FOR CHILD DEVELOPMENT
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3720
Practice Address - Country:US
Practice Address - Phone:718-439-5600
Practice Address - Fax:718-439-5633
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017760235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist