Provider Demographics
NPI:1407542830
Name:GENYUK, MAYYA I
Entity Type:Individual
Prefix:
First Name:MAYYA
Middle Name:
Last Name:GENYUK
Suffix:I
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 1:3100 OCEAN PKWY APT F4
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-8428
Mailing Address - Country:US
Mailing Address - Phone:347-543-5763
Mailing Address - Fax:
Practice Address - Street 1:3100 OCEAN PKWY APT F4
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8428
Practice Address - Country:US
Practice Address - Phone:347-543-5763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist