Provider Demographics
NPI:1801304100
Name:PLYUMYANSKAYA, MARIYA (MS SLP CCC TSSLD)
Entity type:Individual
Prefix:
First Name:MARIYA
Middle Name:
Last Name:PLYUMYANSKAYA
Suffix:
Gender:F
Credentials:MS SLP CCC TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 67TH ST APT A14
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-4330
Mailing Address - Country:US
Mailing Address - Phone:347-334-4541
Mailing Address - Fax:
Practice Address - Street 1:1751 67TH ST APT A14
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-4330
Practice Address - Country:US
Practice Address - Phone:347-334-4541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-21
Last Update Date:2018-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027322-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist