Provider Demographics
NPI:1871855809
Name:NISUYEVA, ELINA (MSED, BCBA, LBA)
Entity Type:Individual
Prefix:MRS
First Name:ELINA
Middle Name:
Last Name:NISUYEVA
Suffix:
Gender:F
Credentials:MSED, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 E 29TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-5317
Mailing Address - Country:US
Mailing Address - Phone:917-509-9792
Mailing Address - Fax:
Practice Address - Street 1:8 IROQUOIS ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-4009
Practice Address - Country:US
Practice Address - Phone:917-509-9792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2019-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist