Individual
YEVGENIY GEROVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1733 SHEEPSHEAD BAY RD STE 12, BROOKLYN, NY 11235-3728
(718) 975-7730
(718) 975-7728
Mailing address
1733 SHEEPSHEAD BAY RD STE 12, BROOKLYN, NY 11235-3728
(718) 975-7730
(718) 975-7728
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1623L001
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720460405
MLTC
NY
Enumeration date
10/20/2017
Last updated
10/20/2017
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