Provider Demographics
NPI:1972151090
Name:LESKIV, IRYNA
Entity type:Individual
Prefix:
First Name:IRYNA
Middle Name:
Last Name:LESKIV
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 1:1230 AVENUE X APT 6E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4231
Mailing Address - Country:US
Mailing Address - Phone:347-754-8404
Mailing Address - Fax:
Practice Address - Street 1:2107 DITMAS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-6903
Practice Address - Country:US
Practice Address - Phone:718-462-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-02
Last Update Date:2019-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
026367235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist