Provider Demographics
NPI:1174082572
Name:KANE, BRIANNA ASHLEY (MASTERS DEGREE)
Entity type:Individual
Prefix:MS
First Name:BRIANNA
Middle Name:ASHLEY
Last Name:KANE
Suffix:
Gender:F
Credentials:MASTERS DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16624 24TH RD
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-4014
Mailing Address - Country:US
Mailing Address - Phone:646-761-0489
Mailing Address - Fax:
Practice Address - Street 1:1201 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10474-5307
Practice Address - Country:US
Practice Address - Phone:718-617-8830
Practice Address - Fax:718-617-8835
Is Sole Proprietor?:No
Enumeration Date:2019-03-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028503235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist