Provider Demographics
NPI:1568730067
Name:ANYA, LLC
Entity Type:Organization
Organization Name:ANYA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VERA
Authorized Official - Middle Name:
Authorized Official - Last Name:KISHINEVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:646-852-7594
Mailing Address - Street 1:21 HAWTHORNE TER
Mailing Address - Street 2:
Mailing Address - City:LEONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07605-1118
Mailing Address - Country:US
Mailing Address - Phone:646-852-7594
Mailing Address - Fax:201-944-8481
Practice Address - Street 1:275 CENTRAL PARK W
Practice Address - Street 2:SUITE 1F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3015
Practice Address - Country:US
Practice Address - Phone:646-852-7594
Practice Address - Fax:201-944-8481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015193-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency