Individual
AMNUN NISIMOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
1642 63RD ST, BROOKLYN, NY 11204-2713
(732) 740-9682
Mailing address
7602 UTOPIA PKWY, FRESH MEADOWS, NY 11366-1518
(347) 394-9896
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
NY
Other
Enumeration date
11/06/2017
Last updated
11/06/2017
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