Provider Demographics
NPI:1962635904
Name:BABAYTSEVA, KATERINA (MA, TSLD, SLP)
Entity Type:Individual
Prefix:
First Name:KATERINA
Middle Name:
Last Name:BABAYTSEVA
Suffix:
Gender:F
Credentials:MA, TSLD, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2284 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4806
Mailing Address - Country:US
Mailing Address - Phone:917-412-6217
Mailing Address - Fax:
Practice Address - Street 1:2284 E 23RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4806
Practice Address - Country:US
Practice Address - Phone:917-412-6217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019405235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist