Provider Demographics
NPI:1366338824
Name:KANG, DAEUN (MS, CCC-SLP, TSSLD)
Entity type:Individual
Prefix:
First Name:DAEUN
Middle Name:
Last Name:KANG
Suffix:
Gender:F
Credentials:MS, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:ESTHER
Other - Middle Name:
Other - Last Name:KANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:515 JACKSON AVE APT 35
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-2441
Mailing Address - Country:US
Mailing Address - Phone:917-886-9277
Mailing Address - Fax:
Practice Address - Street 1:515 JACKSON AVE APT 35
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-2441
Practice Address - Country:US
Practice Address - Phone:917-886-9277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035227235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist