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Organization
VIP HEALTH & FITNESS OT PC
Active
Organization
VIP HEALTH & FITNESS OT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONID YAGUDAYEV OT (PRESIDENT)
(718) 676-2265
Entity
Organization
Contact information
Practice address
1723 ELM AVE, BROOKLYN, NY 11230-5306
(718) 676-2265
(718) 676-2262
Mailing address
1723 ELM AVE, BROOKLYN, NY 11230-5306
(718) 676-2265
(718) 676-2262
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
009163
NY
Other
Enumeration date
10/04/2010
Last updated
10/04/2010
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