MEDICARE: KAITLYN MARIE KIEFER CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist		NY

General Provider Information

NPI Number	:	1568299329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLYN MARIE KIEFER CCC-SLP

Provider Business Mailing Address
First Line	:	92 W CEDARVIEW AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-1710
Country	:	US
Telephone Number	:	718-873-5918
Fax Number	:

Provider Business Practice Location Address
First Line	:	4108 VICTORY BLVD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-6743
Country	:	US
Telephone Number	:	929-464-2438
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2024
Last Update Date	:	04/09/2026

Similar Medicare Providers

1033420450 — MISS KATERINA THEODORACOPOULOS CCC-SLP
Practice Location Address:

4108 VICTORY BLVD
STATEN ISLAND, NY
10314-6743

Practice Phone: 917-975-0593
Practice Fax:

1063787869 — MARY SIRAGUSA RN
Practice Location Address:

4108 VICTORY BLVD
STATEN ISLAND, NY
10314-6743

Practice Phone: 718-698-1530
Practice Fax: 718-982-9798

1619837341 — KAYLEE RITCHIE CCC-SLP
Practice Location Address:

4108 VICTORY BLVD
STATEN ISLAND, NY
10314-6743

Practice Phone: 718-504-5591
Practice Fax:

1982959508 — MS. LISA MARIE ANDERSON
Practice Location Address:

4 CHERRY PL
STATEN ISLAND, NY
10314-6912

Practice Phone: 718-494-6743
Practice Fax:

1174464762 — SHULAMIT WASSERMAN OT
Practice Location Address:

1415 RICHMOND AVE
STATEN ISLAND, NY
10314-1553

Practice Phone: 877-407-3422
Practice Fax: 877-407-4329

1669360814 — NICOLETTE CERBONE FNP
Practice Location Address:

78 TODT HILL RD STE 205
STATEN ISLAND, NY
10314-4528

Practice Phone: 718-447-0781
Practice Fax:

Directions to “ KAITLYN MARIE KIEFER CCC-SLP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.