Provider Demographics
NPI:1861214744
Name:VIKA GABI INC
Entity type:Organization
Organization Name:VIKA GABI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IRENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHMAVONYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:347-445-7575
Mailing Address - Street 1:153 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-4738
Mailing Address - Country:US
Mailing Address - Phone:347-445-7575
Mailing Address - Fax:
Practice Address - Street 1:153 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-4738
Practice Address - Country:US
Practice Address - Phone:347-445-7575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-30
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty