Individual
MIRJANA PETROV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4014 ASTORIA BLVD APT C1, ASTORIA, NY 11103-3628
(347) 430-1930
Mailing address
4014 ASTORIA BLVD APT C1, ASTORIA, NY 11103-3628
(347) 430-1930
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
012516-01
NY
Other
Enumeration date
11/30/2023
Last updated
11/30/2023
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