Individual
EDUARD DOTLIBOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2714 MERMAID AVE, BROOKLYN, NY 11224-2006
(718) 373-8961
(718) 373-8963
Mailing address
2714 MERMAID AVE, BROOKLYN, NY 11224-2006
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F306395
NY
Other
Enumeration date
04/05/2013
Last updated
04/05/2013
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