Provider Demographics
NPI:1083009070
Name:MUNOZ, YULIYA
Entity Type:Individual
Prefix:
First Name:YULIYA
Middle Name:
Last Name:MUNOZ
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 1:6565 WETHEROLE ST
Mailing Address - Street 2:APT 3D
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4764
Mailing Address - Country:US
Mailing Address - Phone:347-585-1788
Mailing Address - Fax:
Practice Address - Street 1:6565 WETHEROLE ST
Practice Address - Street 2:APT 3D
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4764
Practice Address - Country:US
Practice Address - Phone:347-585-1788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2015-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018021-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist