Provider Demographics
NPI:1518262963
Name:ANOSHIN, DMITRY (TSHH)
Entity Type:Individual
Prefix:MR
First Name:DMITRY
Middle Name:
Last Name:ANOSHIN
Suffix:
Gender:M
Credentials:TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 65TH ST APT 22P
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-6501
Mailing Address - Country:US
Mailing Address - Phone:347-445-0900
Mailing Address - Fax:718-833-9778
Practice Address - Street 1:260 65TH ST APT 22P
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-6501
Practice Address - Country:US
Practice Address - Phone:347-445-0900
Practice Address - Fax:718-833-9778
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-17
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1173985235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist