Provider Demographics
NPI:1497123079
Name:SHAPIRSHTEYN, YULIYA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:YULIYA
Middle Name:
Last Name:SHAPIRSHTEYN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6260 99TH ST
Mailing Address - Street 2:#1707
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1842
Mailing Address - Country:US
Mailing Address - Phone:646-379-9191
Mailing Address - Fax:
Practice Address - Street 1:6260 99TH ST
Practice Address - Street 2:#1707
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1842
Practice Address - Country:US
Practice Address - Phone:646-379-9191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-12
Last Update Date:2015-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025016235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist