Provider Demographics
NPI:1336606425
Name:POLOTSKAYA, NATALYA (SLP)
Entity Type:Individual
Prefix:
First Name:NATALYA
Middle Name:
Last Name:POLOTSKAYA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2955 BRIGHTON 4TH ST
Mailing Address - Street 2:GROUND FLOOR, RIGHT DOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-8533
Mailing Address - Country:US
Mailing Address - Phone:718-509-4909
Mailing Address - Fax:718-509-4910
Practice Address - Street 1:2955 BRIGHTON 4TH ST
Practice Address - Street 2:GROUND FLOOR, RIGHT DOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8533
Practice Address - Country:US
Practice Address - Phone:718-509-4909
Practice Address - Fax:718-509-4910
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028500-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist