Provider Demographics
NPI:1740542257
Name:MITELMAN, INNA (MS ED)
Entity type:Individual
Prefix:MRS
First Name:INNA
Middle Name:
Last Name:MITELMAN
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 1:65 OCEANA DR E APT 3C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6688
Mailing Address - Country:US
Mailing Address - Phone:718-872-7765
Mailing Address - Fax:
Practice Address - Street 1:65 OCEANA DR E APT 3C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6688
Practice Address - Country:US
Practice Address - Phone:718-872-7765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist