Provider Demographics
NPI:1538400833
Name:SMOLYANINOV, ANDRIY L (MS ED/SPED)
Entity type:Individual
Prefix:MR
First Name:ANDRIY
Middle Name:L
Last Name:SMOLYANINOV
Suffix:
Gender:M
Credentials:MS ED/SPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2362 E 29TH ST
Mailing Address - Street 2:2F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-5028
Mailing Address - Country:US
Mailing Address - Phone:646-436-2082
Mailing Address - Fax:
Practice Address - Street 1:2362 E 29TH ST
Practice Address - Street 2:2F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5028
Practice Address - Country:US
Practice Address - Phone:646-436-2002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY645461121174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist