Provider Demographics
NPI:1871857037
Name:ARTEMYEV, VALENTINA (SED (MS, ED))
Entity Type:Individual
Prefix:
First Name:VALENTINA
Middle Name:
Last Name:ARTEMYEV
Suffix:
Gender:F
Credentials:SED (MS, ED)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8375 WOODHAVEN BLVD
Mailing Address - Street 2:APT. # 3U
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421-1504
Mailing Address - Country:US
Mailing Address - Phone:917-699-6243
Mailing Address - Fax:
Practice Address - Street 1:8375 WOODHAVEN BLVD
Practice Address - Street 2:APT. # 3U
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-1504
Practice Address - Country:US
Practice Address - Phone:917-699-6243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1289881174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1289881Medicaid