Healthcare Provider Details

I. General information

NPI: 1023939600
Provider Name (Legal Business Name): ANASTASIYA BILOUS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHESEBROUGH ST
STATEN ISLAND NY
10312-3707
US

IV. Provider business mailing address

1 CHESEBROUGH ST
STATEN ISLAND NY
10312-3707
US

V. Phone/Fax

Practice location:
  • Phone: 646-920-0099
  • Fax:
Mailing address:
  • Phone: 646-920-0099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: