Provider Demographics
NPI:1437532686
Name:SLOBODIAN, ALESYA (AUD)
Entity Type:Individual
Prefix:DR
First Name:ALESYA
Middle Name:
Last Name:SLOBODIAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2838 BRIGHAM ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1104
Mailing Address - Country:US
Mailing Address - Phone:347-751-2987
Mailing Address - Fax:
Practice Address - Street 1:2838 BRIGHAM ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-1104
Practice Address - Country:US
Practice Address - Phone:347-751-2987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002590231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist