MEDICARE: YEKATRINA FILL SLUKHINSKY

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
1	174400000X	Specialist	167572	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225005085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YEKATRINA FILL SLUKHINSKY

Provider Business Mailing Address
First Line	:	1659 78TH ST
Second Line	:	SUITE 2D
City	:	BROOKLYN
State	:	NY
Zip	:	11214-1011
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1659 78TH ST
Second Line	:	SUITE 2D
City	:	BROOKLYN
State	:	NY
Zip	:	11214-1011
Country	:	US
Telephone Number	:	718-232-0248
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	10/21/2014

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