Individual
SUSANNA ISAKOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10856 65TH RD, FLUSHING, NY 11375-1843
(917) 514-0004
Mailing address
10856 65TH RD, FOREST HILLS, NY 11375-1843
(917) 514-0004
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
3122065
NY
Other
Enumeration date
11/27/2024
Last updated
11/27/2024
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