Individual
SUSANA BABAYEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
14715 78TH RD, FLUSHING, NY 11367-3535
(718) 971-4961
Mailing address
14715 78TH RD, FLUSHING, NY 11367-3535
(718) 971-4961
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1281076181
NY
Other
Enumeration date
11/28/2018
Last updated
11/28/2018
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