Provider Demographics
NPI:1578361572
Name:CIERNIAK, VIRGINIA EULACIO (MA, LCAT, MT-BC)
Entity type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:EULACIO
Last Name:CIERNIAK
Suffix:
Gender:
Credentials:MA, LCAT, MT-BC
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:CAROLINA
Other - Last Name:EULACIO-GUEVARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, MT-BC
Mailing Address - Street 1:178 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE FERRY
Mailing Address - State:NJ
Mailing Address - Zip Code:07643-1215
Mailing Address - Country:US
Mailing Address - Phone:317-289-0664
Mailing Address - Fax:
Practice Address - Street 1:250 UTICA AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-3931
Practice Address - Country:US
Practice Address - Phone:718-925-2009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002787-01225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist