NPI 1518169648

Iren Shemelyak, LCAC

Practitioner Physical Disabilities Residential Treatment Facility Woodside, NY

Practice location

Address: 6127 Woodside Ave, Woodside, NY 11377-3542
Phone: (646) 644-9780
Fax: (718) 426-4240
Mailing address: 2958 W 8th St Suite 20j, Brooklyn, NY 11224-3223

Registered specialties

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X Licence 001998 (NY)

Other Residential Treatment Facility, Physical Disabilities providers in New York →

Registry record

NPI: 1518169648
Entity type: Individual
Sex (as registered): Female
NPI issued: 1 Jun 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.