Provider Demographics
NPI:1063745917
Name:SHTEYNBERG, YELENA (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:YELENA
Middle Name:
Last Name:SHTEYNBERG
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6735 RIDGE BLVD
Mailing Address - Street 2:APT# 6B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-5248
Mailing Address - Country:US
Mailing Address - Phone:718-680-5957
Mailing Address - Fax:
Practice Address - Street 1:6735 RIDGE BLVD
Practice Address - Street 2:APT# 6B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-5248
Practice Address - Country:US
Practice Address - Phone:718-680-5957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0118541235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist