Provider Demographics
NPI:1215640016
Name:KOSTYRKINA, AKSINYA (BA)
Entity type:Individual
Prefix:MRS
First Name:AKSINYA
Middle Name:
Last Name:KOSTYRKINA
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 W 10TH ST APT C3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-1116
Mailing Address - Country:US
Mailing Address - Phone:347-561-0220
Mailing Address - Fax:
Practice Address - Street 1:1650 W 10TH ST APT C3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1116
Practice Address - Country:US
Practice Address - Phone:347-561-0220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator