Provider Demographics
NPI:1073928198
Name:MOROZOVYCH, MARIIA Y (MS SP ED)
Entity Type:Individual
Prefix:
First Name:MARIIA
Middle Name:Y
Last Name:MOROZOVYCH
Suffix:
Gender:F
Credentials:MS SP ED
Other - Prefix:
Other - First Name:MARIIA
Other - Middle Name:Y
Other - Last Name:KHVALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1541 68TH ST
Mailing Address - Street 2:3D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-6349
Mailing Address - Country:US
Mailing Address - Phone:347-481-6941
Mailing Address - Fax:
Practice Address - Street 1:1100 CONEY ISLAND AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-2344
Practice Address - Country:US
Practice Address - Phone:718-434-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY820258142174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist