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Organization
INDIVIDUAL PROVIDER
Active
Organization
INDIVIDUAL PROVIDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LARISA MISHINA (SPECIAL ED. TEACHER)
(917) 612-5231
Entity
Organization
Contact information
Practice address
3031 BRIGHTON 1ST ST, BROOKLYN, NY 11235-8017
(917) 612-5231
Mailing address
3031 BRIGHTON 1ST ST, BROOKLYN, NY 11235-8017
(917) 612-5231
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
01/30/2013
Last updated
02/02/2013
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