Provider Demographics
NPI:1144583741
Name:DINKEVICH, YELENA (TSHH)
Entity Type:Individual
Prefix:MRS
First Name:YELENA
Middle Name:
Last Name:DINKEVICH
Suffix:
Gender:F
Credentials:TSHH
Other - Prefix:MS
Other - First Name:YELENA
Other - Middle Name:
Other - Last Name:PILYASOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:TSHH
Mailing Address - Street 1:254 QUENTIN RD
Mailing Address - Street 2:4F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-1551
Mailing Address - Country:US
Mailing Address - Phone:718-645-2598
Mailing Address - Fax:
Practice Address - Street 1:254 QUENTIN RD
Practice Address - Street 2:4F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1551
Practice Address - Country:US
Practice Address - Phone:718-645-2598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY273734081252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency