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Individual

ANATOLI YOSHOVAYEV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
7340 172ND ST, FRESH MEADOWS, NY 11366-1421
(718) 291-1513
Mailing address
7340 172ND ST, FRESH MEADOWS, NY 11366-1421
(718) 850-6345

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
029274
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
262275638
TAX ID
NY
01
G300000050
MEDICARE GHI
NY
Enumeration date
02/27/2008
Last updated
12/17/2018
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