Provider Demographics
NPI:1841916475
Name:BUGAILE, KAITLIN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:BUGAILE
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 1:228 E 45TH ST RM 9E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-3337
Mailing Address - Country:US
Mailing Address - Phone:212-812-8054
Mailing Address - Fax:
Practice Address - Street 1:228 E 45TH ST RM 9E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-3337
Practice Address - Country:US
Practice Address - Phone:212-812-8054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010010235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist