Healthcare Provider Details

I. General information

NPI: 1275024721
Provider Name (Legal Business Name): KAYLA ELIZABETH VIGNOLA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2018
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 PENINSULA BLVD
HEMPSTEAD NY
11550-4900
US

IV. Provider business mailing address

185 PENINSULA BLVD
HEMPSTEAD NY
11550-4900
US

V. Phone/Fax

Practice location:
  • Phone: 516-292-7111
  • Fax:
Mailing address:
  • Phone: 516-292-7111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number034655
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: