Individual
ANATOLY MASTEROVOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
87 EAGAN AVE, STATEN ISLAND, NY 10312-4103
(718) 356-3917
Mailing address
87 EAGAN AVE, STATEN ISLAND, NY 10312-4103
(718) 356-3917
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/20/2013
Last updated
08/20/2013
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