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NPI Code Detail

MEDICARE: MS. OLGA DYAKOVA LMSW

MEDICARE:  MS. OLGA  DYAKOVA  LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker067486-1NY

General Provider Information

NPI Number : 1184719825
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. OLGA DYAKOVA LMSW
Provider Business Mailing Address
First Line : 2018 VOORHIES AVE
Second Line : APT. A15
City : BROOKLYN
State : NY
Zip : 11235-2942
Country : US
Telephone Number : 718-769-5150
Fax Number :
Provider Business Practice Location Address
First Line : 333 AVENUE X
Second Line :
City : BROOKLYN
State : NY
Zip : 11223-5947
Country : US
Telephone Number : 718-339-5300
Fax Number : 718-339-9082
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 07/08/2007

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Directions to “ MS. OLGA DYAKOVA LMSW” Practice Location

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