Provider Demographics
NPI:1306311618
Name:VIKNORINA CARE INC
Entity type:Organization
Organization Name:VIKNORINA CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATOR
Authorized Official - Prefix:
Authorized Official - First Name:ASTGHIK
Authorized Official - Middle Name:
Authorized Official - Last Name:SHMAVONYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:718-879-2565
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:917-957-5717
Mailing Address - Fax:
Practice Address - Street 1:1746 71ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-5225
Practice Address - Country:US
Practice Address - Phone:718-879-2565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty