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Individual

NERIK SHAMALOV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
18616 80TH DR, JAMAICA, NY 11432-5805
(917) 515-0149
Mailing address
18616 80TH DR, JAMAICA, NY 11432-5805
(917) 515-0149

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary

Other

Enumeration date
12/28/2013
Last updated
12/28/2013
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