Provider Demographics
NPI:1790099729
Name:VOROBEYCHIK, ANTONINA (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANTONINA
Middle Name:
Last Name:VOROBEYCHIK
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 LANGHAM STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2301
Mailing Address - Country:US
Mailing Address - Phone:347-622-3493
Mailing Address - Fax:
Practice Address - Street 1:131 LANGHAM STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2301
Practice Address - Country:US
Practice Address - Phone:347-622-3493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020763-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist