Healthcare Provider Details

I. General information

NPI: 1548185457
Provider Name (Legal Business Name): KID SPEECH LANGUAGE PATHOLOGY P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 WASHINGTON STREET #9J
BROOKLYN NY
11201
US

IV. Provider business mailing address

228 PARK AVE S PMB 448357
NEW YORK NY
10003-0103
US

V. Phone/Fax

Practice location:
  • Phone: 917-524-8111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KAROLINA RADZIWILLOWICZ
Title or Position: PRESIDENT
Credential: M.S., CCC-SLP
Phone: 917-524-8111