Organization
DEKHTYAREV PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEKSANDR DEKHTYAREV DPT (PRESIDENT)
19175385175
Entity
Organization
Contact information
Practice address
1811 QUENTIN RD, BROOKLYN, NY 11229-1343
(917) 538-5175
Mailing address
2044 E 18TH ST APT 2F, BROOKLYN, NY 11229-3836
(917) 538-5175
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
030526
NY
Other
Enumeration date
08/26/2009
Last updated
08/26/2009
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