Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 180440 | NY |
Y | 103T00000X | Psychologist | 180440 | NY |
NPI | 1003943101 |
---|---|
Provider Name | Mrs. Emilya Mizhiritskaya |
First Address | Brooklyn, NY 11235-4932 |
Second Address | Brooklyn, NY 11235 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 02/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01181864 | (05) | NY |
E40733 | (02) |