Individual
PAVEL DIANOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
311 11TH AVE, NEW YORK, NY 10001-1394
(646) 645-9812
Mailing address
31 RIVER CT APT 1010, JERSEY CITY, NJ 07310-2024
(646) 645-9812
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
033453
NY
Other
Enumeration date
10/24/2023
Last updated
10/24/2023
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