Individual
VLADISLAV KOROSTYSHEVSKIY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
2678 OCEAN AVE APT 2E, BROOKLYN, NY 11229-4684
(718) 513-3736
Mailing address
2678 OCEAN AVE APT 2E, BROOKLYN, NY 11229-4684
(718) 513-3736
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
001526
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1122334455
N/A
NY
Enumeration date
11/03/2019
Last updated
11/03/2019
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