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Contact Information

KAITLYN E BOULUKOS, M.S CCC-SLP
3 MILLER AVENUE
SHOREHAM, NY11786
 Phone: 631-821-8231
 Fax: 631-821-8249
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
Indicates primary specialty

NPI Profile & details for KAITLYN E BOULUKOS · (Female)

NPI # 1275841165
Status Active
Credentials M.S CCC-SLP
Entity Individual
Enumeration date 09/14/2010
Last updated 04/09/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 021000-1
  • NY License # 1170343
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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