Provider Demographics
NPI:1114217122
Name:KORECKAYA, OKSANA (AP)
Entity Type:Individual
Prefix:DR
First Name:OKSANA
Middle Name:
Last Name:KORECKAYA
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 YACHT CLUB CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH REDINGTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33708-1583
Mailing Address - Country:US
Mailing Address - Phone:718-755-3335
Mailing Address - Fax:
Practice Address - Street 1:3501 1ST AVE S
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33711-1303
Practice Address - Country:US
Practice Address - Phone:718-755-3335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2872171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist