Individual
DMITRIY YESIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
465 GRAND ST, NEW YORK, NY 10002-4800
(212) 420-1999
Mailing address
2775 E 12TH ST APT 416, BROOKLYN, NY 11235-4616
(347) 851-0361
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
910944
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
800693122
—
NY
Enumeration date
05/12/2019
Last updated
05/12/2019
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