Individual
ELLY CHAFIZOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1434 E 19TH ST, BROOKLYN, NY 11230-6716
(718) 755-3218
Mailing address
1434 E 19TH ST, BROOKLYN, NY 11230-6716
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
018914-1
NY
Other
Enumeration date
08/04/2014
Last updated
08/04/2014
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