Individual
MARAT AVSHALUMOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
100 MERRICK RD STE 128W, ROCKVILLE CENTRE, NY 11570-4821
(516) 255-9031
(516) 255-6010
Mailing address
100 MERRICK RD STE 128W, ROCKVILLE CENTRE, NY 11570-4821
(516) 255-9031
(516) 255-6010
Taxonomy
Speciality
Code
Description
License number
State
246ZE0500X
EEG Specialist/Technologist
Primary
1462
NY
Other
Enumeration date
06/12/2009
Last updated
06/12/2009
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