Provider Demographics
NPI:1649527870
Name:MIKHAYLOVSKAYA, VERONIKA (MS, ED)
Entity type:Individual
Prefix:MRS
First Name:VERONIKA
Middle Name:
Last Name:MIKHAYLOVSKAYA
Suffix:
Gender:F
Credentials:MS, ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 E 74TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6604
Mailing Address - Country:US
Mailing Address - Phone:646-220-7080
Mailing Address - Fax:
Practice Address - Street 1:2250 E 74TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-6604
Practice Address - Country:US
Practice Address - Phone:646-220-7080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency