Individual
AMY AVSHALUMOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9412 4TH AVE, BROOKLYN, NY 11209-7301
(718) 745-3456
Mailing address
9412 4TH AVE, BROOKLYN, NY 11209-7301
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
058494
NY
Other
Enumeration date
06/30/2015
Last updated
02/25/2025
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