Individual
ANTONINA YUSHUVAYEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NY
252Y00000X
Early Intervention Provider Agency
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891058657
SPECIAL INSTRUCTOR TEACHER
NY
Enumeration date
06/18/2012
Last updated
11/06/2015
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