INDIVIDUAL PROVIDER NPI 1538407259

NPI Information

INDIVIDUAL PROVIDER is a specialist in Brooklyn, NY. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. INDIVIDUAL PROVIDER NPI is 1538407259. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3031 BRIGHTON 1ST ST
BROOKLYN, NY
ZIP 11235-017
Phone: (917) 612-5231

The provider's authorized official is Larisa Mishina .
The authorized official title is Special Ed. Teacher and has the following contact phone number (917) 612-5231.

The enumeration date for this NPI number is 1/30/2013 and was last updated on 2/2/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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