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Individual

MR. ALEXANDER MINEVICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTR/L

Contact information

Practice address
1619 3RD AVE APT 18A, NEW YORK, NY 10128-0063
(954) 789-9200
Mailing address
1619 3RD AVE APT 18A, NEW YORK, NY 10128-0063
(917) 227-9447
(770) 514-8511

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
029389
NY
225XP0200X
Pediatric Occupational Therapist
OT003641
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000965643E
GA
Enumeration date
09/20/2006
Last updated
12/13/2024
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