Individual
MR. VICTOR ABUSERIDZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2145 OCEAN AVENUE, APT. 9A, BROOKLYN, NY 11229
(347) 549-6512
Mailing address
2145 OCEAN AVE APT A9, BROOKLYN, NY 11229-1470
(347) 549-6512
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHACERTIFICATEA00483
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A00483
HHA CERTIFICATE
NY
Enumeration date
07/11/2013
Last updated
08/09/2013
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