Provider Demographics
NPI:1972058493
Name:KERNAN, BRAYLEAH (SLP-CF)
Entity type:Individual
Prefix:MISS
First Name:BRAYLEAH
Middle Name:
Last Name:KERNAN
Suffix:
Gender:F
Credentials:SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 E 51ST ST APT 2A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-7852
Mailing Address - Country:US
Mailing Address - Phone:321-431-3683
Mailing Address - Fax:
Practice Address - Street 1:358 E 51ST ST APT 2A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-7852
Practice Address - Country:US
Practice Address - Phone:321-431-3683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist