Provider Demographics
NPI:1386956365
Name:KULIK, TATYANA (MS)
Entity type:Individual
Prefix:MRS
First Name:TATYANA
Middle Name:
Last Name:KULIK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 GIFFORDS LN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10308-2069
Mailing Address - Country:US
Mailing Address - Phone:718-317-7227
Mailing Address - Fax:
Practice Address - Street 1:174 GIFFORDS LN
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10308-2069
Practice Address - Country:US
Practice Address - Phone:718-317-7227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist