Individual
DIANA IVAYLOVA NIKOLAEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1230 PARKWAY AVE STE 205, EWING, NJ 08628-3018
(609) 883-7528
(609) 883-5947
Mailing address
1230 PARKWAY AVE STE 205, EWING, NJ 08628-3018
(609) 883-7528
(609) 883-5947
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00412000
NJ
Other
Enumeration date
01/09/2024
Last updated
01/09/2024
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