Individual
ANNA FYODOROVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
813 QUENTIN RD, SUITE 200, BROOKLYN, NY 11223-2251
(718) 998-9890
(718) 998-9891
Mailing address
813 QUENTIN RD, SUITE 200, BROOKLYN, NY 11223-2251
(718) 998-9890
(718) 998-9891
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
028955
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028955-1
STATE LICENSE
NY
Enumeration date
01/16/2007
Last updated
11/25/2008
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