Healthcare Provider Details

I. General information

NPI: 1407780877
Provider Name (Legal Business Name): KAILA RENEE FRITH AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1336 UTICA AVE
BROOKLYN NY
11203-5912
US

IV. Provider business mailing address

890 HEMPSTEAD BLVD
UNIONDALE NY
11553-2435
US

V. Phone/Fax

Practice location:
  • Phone: 718-833-5867
  • Fax: 718-833-5866
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number003368
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: