Individual
MS. INNA GANKINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2645 HOMECREST AVE APT 1D, BROOKLYN, NY 11235-4531
(917) 470-4739
Mailing address
2645 HOMECREST AVE APT 1D, BROOKLYN, NY 11235-4531
(917) 470-4739
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
2406585
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2406585
TEACHER'S LICENSE
NY
Enumeration date
06/18/2012
Last updated
06/18/2012
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