Provider Demographics
NPI:1346750387
Name:KALIANKEVICH, VERANIKA
Entity type:Individual
Prefix:
First Name:VERANIKA
Middle Name:
Last Name:KALIANKEVICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 SHADYBROOK LN
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4610
Mailing Address - Country:US
Mailing Address - Phone:631-935-2981
Mailing Address - Fax:
Practice Address - Street 1:254 SHADYBROOK LN
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4610
Practice Address - Country:US
Practice Address - Phone:631-935-2981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY738347-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health