Provider Demographics
NPI:1689946899
Name:HUDUMAK, NATALIYA
Entity Type:Individual
Prefix:MS
First Name:NATALIYA
Middle Name:
Last Name:HUDUMAK
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:NATALIYA
Other - Middle Name:
Other - Last Name:HUDUMAK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS,CCC-SLP
Mailing Address - Street 1:921 RODER AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5757
Mailing Address - Country:US
Mailing Address - Phone:718-744-8544
Mailing Address - Fax:
Practice Address - Street 1:625 FULTON ST
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-7416
Practice Address - Country:US
Practice Address - Phone:718-744-8544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021685235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist