Individual
EMA AVEZOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6393 WOODHAVEN BLVD, APT#4C, REGO PARK, NY 11374-4843
(917) 693-8465
Mailing address
6393 WOODHAVEN BLVD, APT#4C, REGO PARK, NY 11374-4843
(917) 693-8465
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
019688
NY
Other
Enumeration date
03/31/2016
Last updated
10/18/2021
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