Individual
SAM KOVALYOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
108 MAIN ST, LIVINGSTON MANOR, NY 12758-5112
(845) 707-6265
Mailing address
104 MAIN ST, LIVINGSTON MANOR, NY 12758-5112
(845) 707-6265
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
12/05/2025
Last updated
12/05/2025
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