Individual
RAISA MYKHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
220 RICHMOND HILL RD, STATEN ISLAND, NY 10314-5988
(718) 687-2678
Mailing address
220 RICHMOND HILL RD, STATEN ISLAND, NY 10314-5988
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
10/22/2021
Last updated
10/22/2021
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