Provider Demographics
NPI:1528471182
Name:DEMIDENKO, DARIA
Entity type:Individual
Prefix:
First Name:DARIA
Middle Name:
Last Name:DEMIDENKO
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 1:800 OCEAN PKWY
Mailing Address - Street 2:APT. 3N
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-2185
Mailing Address - Country:US
Mailing Address - Phone:347-524-2518
Mailing Address - Fax:
Practice Address - Street 1:800 OCEAN PKWY
Practice Address - Street 2:APT. 3N
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-2185
Practice Address - Country:US
Practice Address - Phone:347-524-2518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist