Provider Demographics
NPI:1609618149
Name:KAZIMER, SAMANTHA L
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:L
Last Name:KAZIMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 GALBRO CIR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-1760
Mailing Address - Country:US
Mailing Address - Phone:585-506-6501
Mailing Address - Fax:
Practice Address - Street 1:572 GALBRO CIR
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-1760
Practice Address - Country:US
Practice Address - Phone:585-506-6501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist