Provider Demographics
NPI:1538606553
Name:SLUKHINSKY, SUSANNA (RD, CDN)
Entity type:Individual
Prefix:MRS
First Name:SUSANNA
Middle Name:
Last Name:SLUKHINSKY
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2736 OCEAN AVE
Mailing Address - Street 2:5C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4705
Mailing Address - Country:US
Mailing Address - Phone:718-419-3906
Mailing Address - Fax:
Practice Address - Street 1:2736 OCEAN AVE
Practice Address - Street 2:5C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4705
Practice Address - Country:US
Practice Address - Phone:718-419-3906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-28
Last Update Date:2017-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY86029744133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered