Provider Demographics
NPI:1023434073
Name:PRUZHANSKY, LYUDMILA
Entity type:Individual
Prefix:
First Name:LYUDMILA
Middle Name:
Last Name:PRUZHANSKY
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 1:2201 AVENUE X
Mailing Address - Street 2:APT. 3F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2540
Mailing Address - Country:US
Mailing Address - Phone:347-275-1615
Mailing Address - Fax:
Practice Address - Street 1:2201 AVENUE X
Practice Address - Street 2:APT. 3F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2540
Practice Address - Country:US
Practice Address - Phone:347-275-1615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator