Individual
IRINA GRIGORYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4 SEIDMAN AVE, STATEN ISLAND, NY 10312-5023
(718) 715-8222
Mailing address
4 SEIDMAN AVE, STATEN ISLAND, NY 10312-5023
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
890817840
N/A
—
Enumeration date
07/02/2019
Last updated
07/02/2019
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