Individual Provider
Individual Provider provides Specialist services in Brooklyn, New York. Registered with an NPI since 2013.
- In the registry since
- 2013
Practice location Address checks out
3031 Brighton 1st StBrooklyn, NY 11235-8017 Not confirmed with CMS for 13 years — call before visiting
Phone: (917) 612-5231
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Specialist (primary) | Taxonomy 174400000X |
|---|
Record details
| NPI number | 1538407259 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Larisa Mishina — Special Ed. Teacher · (917) 612-5231 |
| NPI enumerated | January 30, 2013 |
| Last updated in NPPES | February 2, 2013 |
| Mailing address | 3031 Brighton 1st St, Brooklyn, NY 11235-8017 |
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