Individual
ALLA NIYAZOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
14049 69TH RD, FLUSHING, NY 11367-1615
(917) 403-3077
Mailing address
14049 69TH RD, FLUSHING, NY 11367-1615
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
008902
NY
Other
Enumeration date
02/29/2016
Last updated
03/30/2020
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