Provider Demographics
NPI:1922315753
Name:BIRK, LUDMILA (SPECIAL EDUCATION T)
Entity Type:Individual
Prefix:
First Name:LUDMILA
Middle Name:
Last Name:BIRK
Suffix:
Gender:F
Credentials:SPECIAL EDUCATION T
Other - Prefix:
Other - First Name:LUDMILA
Other - Middle Name:
Other - Last Name:KHODIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SPECIAL ED TEACHER
Mailing Address - Street 1:22007 KINGSBURY AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-3536
Mailing Address - Country:US
Mailing Address - Phone:917-817-7816
Mailing Address - Fax:718-217-1673
Practice Address - Street 1:22007 KINGSBURY AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-3536
Practice Address - Country:US
Practice Address - Phone:917-817-7816
Practice Address - Fax:718-217-1673
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist