MEDICARE: DIANA STRATIICHUK

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	103K00000X	Behavior Analyst	1945715251	NY

General Provider Information

NPI Number	:	1588536106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA STRATIICHUK

Provider Business Mailing Address
First Line	:	85 BURBANK AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2318
Country	:	US
Telephone Number	:	347-765-4023
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 BURBANK AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2318
Country	:	US
Telephone Number	:	347-765-4023
Fax Number	:

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

Provider Enumeration Date	:	09/22/2025
Last Update Date	:	09/22/2025

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Directions to “ DIANA STRATIICHUK ” Practice Location

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