Individual provider Active NPI

Valeriia Shushkevych

  • Early Intervention Provider Agency
  • Brooklyn, NY
National Provider Identifier
1154145308
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
1596302221 Issued in NY
Practice address
2695 Shell Rd Apt 1D
Brooklyn, NY 11223-6105
Phone
(631) 800-6113
NPI assigned
Nov 14, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 1596302221 NY Primary

Addresses

Primary practice location

2695 Shell Rd Apt 1D
Brooklyn, NY 11223-6105

Mailing address

2695 Shell Rd Apt 1D
Brooklyn, NY 11223-6105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1596302221NYMDEarly Intervention Provider Agency

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1731542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1154145308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 SHELL RD APT 1D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112236105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2695 SHELL RD APT 1D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112236105",
            "telephone_number": "631-800-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUSHKEVYCH",
        "first_name": "VALERIIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-14",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "1596302221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.