Individual
YEVGENIYA PETRUSHINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
1771 E 31ST ST, BROOKLYN, NY 11234-4437
(917) 667-4358
Mailing address
1771 E 31ST ST, BROOKLYN, NY 11234-4437
(917) 667-4358
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1701896231
NY
Other
Enumeration date
05/01/2023
Last updated
05/08/2023
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