Provider Demographics
NPI:1477095743
Name:AELRI, LIUDMILA
Entity Type:Individual
Prefix:
First Name:LIUDMILA
Middle Name:
Last Name:AELRI
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 1:1229 AVENUE Y APT 6C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4225
Mailing Address - Country:US
Mailing Address - Phone:917-500-9790
Mailing Address - Fax:
Practice Address - Street 1:1229 AVENUE Y APT 6C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4225
Practice Address - Country:US
Practice Address - Phone:917-500-9790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-17
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010520-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health