Provider Demographics
NPI:1376809764
Name:DANILOVA, RUFINA (AUD,)
Entity Type:Individual
Prefix:
First Name:RUFINA
Middle Name:
Last Name:DANILOVA
Suffix:
Gender:F
Credentials:AUD,
Other - Prefix:
Other - First Name:RUFINA
Other - Middle Name:
Other - Last Name:YAKUBOV
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUD,
Mailing Address - Street 1:1311 BRIGHTWATER AVE APT 12J
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5931
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1311 BRIGHTWATER AVE APT 12J
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5931
Practice Address - Country:US
Practice Address - Phone:718-490-7195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-10
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002336231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY002336OtherLICENSE NUMBER