Provider Demographics
NPI:1922514736
Name:NOVAKHOVA-RIBENBACH, YANA
Entity Type:Individual
Prefix:
First Name:YANA
Middle Name:
Last Name:NOVAKHOVA-RIBENBACH
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 1:82 SHOREHAM WAY
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-5028
Mailing Address - Country:US
Mailing Address - Phone:917-533-3785
Mailing Address - Fax:
Practice Address - Street 1:82 SHOREHAM WAY
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-5028
Practice Address - Country:US
Practice Address - Phone:917-533-3785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-17
Last Update Date:2017-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty