MEDICARE: MRS. YULIYA LOGIAN

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1619483773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YULIYA LOGIAN

Provider Business Mailing Address
First Line	:	11840 METROPOLITAN AVE APT 6D
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-2014
Country	:	US
Telephone Number	:	646-624-9561
Fax Number	:

Provider Business Practice Location Address
First Line	:	11840 METROPOLITAN AVE APT 6D
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-2014
Country	:	US
Telephone Number	:	646-624-9561
Fax Number	:

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

Provider Enumeration Date	:	12/27/2017
Last Update Date	:	12/27/2017

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Directions to “ MRS. YULIYA LOGIAN ” Practice Location

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