Provider Demographics
NPI:1194562942
Name:PRONIN, KATERINA (MS)
Entity type:Individual
Prefix:
First Name:KATERINA
Middle Name:
Last Name:PRONIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KATYA
Other - Middle Name:
Other - Last Name:PRONIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:880 3RD AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4730
Mailing Address - Country:US
Mailing Address - Phone:212-305-5289
Mailing Address - Fax:
Practice Address - Street 1:880 3RD AVE FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4730
Practice Address - Country:US
Practice Address - Phone:212-305-5289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP128970235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist