Individual
IOSIF KIMATOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
30-63 38 ST, ASTORIA, NY 11103
(718) 932-1269
Mailing address
3063 38TH ST, ASTORIA, NY 11103-4172
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
01232001
NY
Other
Enumeration date
06/14/2021
Last updated
06/14/2021
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