Provider Demographics
NPI:1639560634
Name:ZEMKO, TATYANA (MS/ED)
Entity Type:Individual
Prefix:
First Name:TATYANA
Middle Name:
Last Name:ZEMKO
Suffix:
Gender:F
Credentials:MS/ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2471 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-6041
Mailing Address - Country:US
Mailing Address - Phone:917-531-6454
Mailing Address - Fax:
Practice Address - Street 1:2471 E 2ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-6041
Practice Address - Country:US
Practice Address - Phone:917-531-6454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1175927174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist