Provider Demographics
NPI:1700148749
Name:SUVOROVSKAYA, GENRIETA (PHD MUSIC, MD SPED)
Entity Type:Individual
Prefix:MS
First Name:GENRIETA
Middle Name:
Last Name:SUVOROVSKAYA
Suffix:
Gender:F
Credentials:PHD MUSIC, MD SPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3096 BRIGHTON 6TH ST
Mailing Address - Street 2:APARTMENT E-6
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6951
Mailing Address - Country:US
Mailing Address - Phone:347-370-8177
Mailing Address - Fax:
Practice Address - Street 1:3096 BRIGHTON 6TH ST
Practice Address - Street 2:APARTMENT E-6
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6951
Practice Address - Country:US
Practice Address - Phone:347-370-8177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist