Provider Demographics
NPI:1427406107
Name:BRISK, YIRA (MS)
Entity Type:Individual
Prefix:
First Name:YIRA
Middle Name:
Last Name:BRISK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 CLYMER ST
Mailing Address - Street 2:#35
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-7153
Mailing Address - Country:US
Mailing Address - Phone:917-635-3305
Mailing Address - Fax:929-298-0217
Practice Address - Street 1:186 CLYMER ST
Practice Address - Street 2:#35
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-7153
Practice Address - Country:US
Practice Address - Phone:917-635-3305
Practice Address - Fax:929-298-0217
Is Sole Proprietor?:No
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist