Provider Demographics
NPI:1821700071
Name:STURISKY, ILANA MICHELLE
Entity Type:Individual
Prefix:
First Name:ILANA
Middle Name:MICHELLE
Last Name:STURISKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E 33RD ST APT 17G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4829
Mailing Address - Country:US
Mailing Address - Phone:770-296-7739
Mailing Address - Fax:
Practice Address - Street 1:540 PRESIDENT ST STE 2D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-1490
Practice Address - Country:US
Practice Address - Phone:718-288-1845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist