Individual
ANTONINA NEFEDOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15 JESSICA CT, STATEN ISLAND, NY 10312-3653
(718) 844-1314
Mailing address
15 JESSICA CT, STATEN ISLAND, NY 10312-3653
(718) 844-1314
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/22/2021
Last updated
06/22/2021
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