Provider Demographics
NPI:1174295380
Name:GIRKHOVSKIY, RUSLANA
Entity Type:Individual
Prefix:
First Name:RUSLANA
Middle Name:
Last Name:GIRKHOVSKIY
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 1:2155 82ND ST APT 4N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-2564
Mailing Address - Country:US
Mailing Address - Phone:917-535-0024
Mailing Address - Fax:
Practice Address - Street 1:2155 82ND ST APT 4N
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-2564
Practice Address - Country:US
Practice Address - Phone:917-535-0024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty