Active NPIIndividual providerSole proprietor

Mr. Kieran M Shine, MA, CCC-SLP

Speech-Language Pathologist, in Bronxville, New York

NPI Number1710425467
Practice location
1 Georgia Ave, Apt. 6A, Bronxville, NY 10708-6222
Fax
—
Last updated
February 2, 2017

Kieran M. Shine is a Speech-Language Pathologist, based in Bronxville, NY. Kieran M. Shine practices in Bronxville, NY and has the professional credentials of MA, CCC-SLP. The NPI Number for Kieran M. Shine is 1710425467 and holds a License No. 017966-1 (NY). The current practice location address for Kieran M. Shine is 1 Georgia Ave, Apt. 6A, Bronxville, NY 10708-6222 and can be reached out via phone at 845-649-4871.

Provider Profile Details

NPI Number
1710425467
Provider Name
Kieran M. Shine
Credential
MA, CCC-SLP
Provider Entity Type
Individual
Gender
Male
Address
1 Georgia Ave, Apt. 6A, Bronxville, NY 10708-6222
Phone Number
845-649-4871
Primary Taxonomy
Speech-Language Pathologist, · 235Z00000X
Sole Proprietor
Yes
Provider Enumeration Date
February 2, 2017
Last Update Date
February 2, 2017
NPI Status
Active

Provider Business Practice Location Address Details

Address
1 Georgia Ave
Apt. 6A
Bronxville, NY 10708-6222
Zip
10708-6222
Phone Number
845-649-4871
Bronxville, NY 10708Get directions →

Provider Business Mailing Address Details

Address
1 Georgia Ave
Apt. 6A
Bronxville, NY 10708-6222
City
Bronxville
State
NY
Zip
10708-6222
Phone Number
845-649-4871

License Information

License Number
017966-1
License State
NY
Taxonomy
Speech-Language Pathologist, · 235Z00000X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Mr. Kieran M Shine, MA, CCC-SLP?

The NPI number of Mr. Kieran M Shine, MA, CCC-SLP is 1710425467. It was assigned on February 2, 2017 and is currently active in the NPPES registry.

What is the specialty of Mr. Kieran M Shine, MA, CCC-SLP?

Mr. Kieran M Shine, MA, CCC-SLP is registered under the primary taxonomy Speech-Language Pathologist, (code 235Z00000X), licensed in NY under license number 017966-1.

Where does Mr. Kieran M Shine, MA, CCC-SLP practice?

The practice location is 1 Georgia Ave, Apt. 6A, Bronxville, NY 10708-6222. The office can be reached at 845-649-4871 (phone).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1710425467 directly on the NPPES registry website.

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