Individual
MR. MIKHAIL AZERNOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
189 WHEATLEY RD, GLEN HEAD, NY 11545-2641
(516) 686-4496
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-76662
NY
Other
Enumeration date
12/02/2021
Last updated
04/06/2025
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