Provider Demographics
NPI:1407390040
Name:SCHIRALDI, KAITLIN (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:SCHIRALDI
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24-30 SKILLMAN AVE
Mailing Address - Street 2:
Mailing Address - City:LONG ISLANND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101
Mailing Address - Country:US
Mailing Address - Phone:516-547-7617
Mailing Address - Fax:
Practice Address - Street 1:24-30 SKILLMAN AVE
Practice Address - Street 2:
Practice Address - City:LONG ISLANND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101
Practice Address - Country:US
Practice Address - Phone:516-547-7617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-16
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021619235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist