Provider Demographics
NPI:1942534920
Name:SHLEYMOVICH, INNA K (MD)
Entity Type:Individual
Prefix:
First Name:INNA
Middle Name:K
Last Name:SHLEYMOVICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:INNA
Other - Middle Name:
Other - Last Name:KAVALERCHIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 E 33RD ST APT 31J
Mailing Address - Street 2:SUITE 31J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4832
Mailing Address - Country:US
Mailing Address - Phone:917-448-0247
Mailing Address - Fax:
Practice Address - Street 1:200 E 33RD ST APT 31J
Practice Address - Street 2:SUITE 31J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4832
Practice Address - Country:US
Practice Address - Phone:917-448-0247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY2692812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program