Healthcare Provider Details

I. General information

NPI: 1003729161
Provider Name (Legal Business Name): KENDRA GUZMAN LUCERO M.A., CF-SLP, TSSLD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 AMBER LN
OYSTER BAY NY
11771-3115
US

IV. Provider business mailing address

1844 WATSON AVE
BRONX NY
10472-5437
US

V. Phone/Fax

Practice location:
  • Phone: 347-270-8850
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: