Provider Demographics
NPI:1497572721
Name:KRASNOKUTSKAYA, YANA (MS)
Entity type:Individual
Prefix:
First Name:YANA
Middle Name:
Last Name:KRASNOKUTSKAYA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 NEPTUNE AVE APT 3B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-4467
Mailing Address - Country:US
Mailing Address - Phone:646-925-1876
Mailing Address - Fax:
Practice Address - Street 1:2571 E 17TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3585
Practice Address - Country:US
Practice Address - Phone:718-412-9777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1823895241174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist