Individual
ANATOLY STAROSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1704 MERMAID AVE, BROOKLYN, NY 11224-2622
(718) 265-0900
Mailing address
1704 MERMAID AVE, BROOKLYN, NY 11224-2622
(718) 265-0900
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
018716
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02193199
—
NY
Enumeration date
03/24/2006
Last updated
04/09/2010
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