Provider Demographics
NPI:1528291226
Name:KASSIMIS, MARIA (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:KASSIMIS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 48TH ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-1524
Mailing Address - Country:US
Mailing Address - Phone:718-728-3919
Mailing Address - Fax:718-728-3919
Practice Address - Street 1:8902 32ND AVE
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11369-2238
Practice Address - Country:US
Practice Address - Phone:718-898-8181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018440235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist