Individual
NATALLIA PETRUSHENKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
444 STOCKBRIDGE RD, GREAT BARRINGTON, MA 01230-1295
(413) 528-9311
Mailing address
1200 HILLSIDE AVE APT 501, NISKAYUNA, NY 12309-3559
(929) 428-1102
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1860022
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/09/2023
Last updated
11/14/2023
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