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Organization

FIRST CHOICE PT SLP PSYCHOLOGY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LEONID YAKUBOV OT (EXECUTIVE DIRECTOR)
(718) 213-3041
Entity
Organization

Contact information

Practice address
8415 BEVERLY RD, KEW GARDENS, NY 11415-2103
(718) 213-3041
Mailing address
8415 BEVERLY RD, KEW GARDENS, NY 11415-2103
(718) 213-3041

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
NY

Other

Enumeration date
11/03/2015
Last updated
11/03/2015
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