Provider Demographics
NPI:1558489443
Name:SHAKAROVA, SVETLANA (MS)
Entity Type:Individual
Prefix:MS
First Name:SVETLANA
Middle Name:
Last Name:SHAKAROVA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6620 108TH ST
Mailing Address - Street 2:1G
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2251
Mailing Address - Country:US
Mailing Address - Phone:718-896-2487
Mailing Address - Fax:
Practice Address - Street 1:1670-78 EAST 17TH STREET
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229
Practice Address - Country:US
Practice Address - Phone:718-375-1200
Practice Address - Fax:718-382-3358
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health