Provider Demographics
NPI:1497413504
Name:SHUBAEV, JULIET GALIT
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:GALIT
Last Name:SHUBAEV
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 1:25 COVE LN APT 3A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6071
Mailing Address - Country:US
Mailing Address - Phone:347-600-2525
Mailing Address - Fax:
Practice Address - Street 1:1955 MCDONALD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1805
Practice Address - Country:US
Practice Address - Phone:718-787-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker