Provider Demographics
NPI:1073821732
Name:KRUTOY, YULIANA (SLP)
Entity Type:Individual
Prefix:MISS
First Name:YULIANA
Middle Name:
Last Name:KRUTOY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:YULIANA
Other - Middle Name:
Other - Last Name:AVSHALUMOV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1820 AVENUE N APT 6C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-6169
Mailing Address - Country:US
Mailing Address - Phone:917-609-4549
Mailing Address - Fax:
Practice Address - Street 1:1520 E 13TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-7106
Practice Address - Country:US
Practice Address - Phone:718-382-1060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021049-01235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist