Healthcare Provider Details

I. General information

NPI: 1396652954
Provider Name (Legal Business Name): MARIYA YARSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 W END AVE APT 12MC
NEW YORK NY
10023-2683
US

IV. Provider business mailing address

277 W END AVE APT 12MC
NEW YORK NY
10023-2683
US

V. Phone/Fax

Practice location:
  • Phone: 646-280-9667
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number005213
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: