Provider Demographics
NPI:1396561965
Name:POZNYAKOV, AMANDA G
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:G
Last Name:POZNYAKOV
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 1:113 OXFORD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2310
Mailing Address - Country:US
Mailing Address - Phone:718-637-3744
Mailing Address - Fax:
Practice Address - Street 1:2959 AVENUE Y
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-1624
Practice Address - Country:US
Practice Address - Phone:718-233-9098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-28
Last Update Date:2024-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst