Individual
ALINA VAYSBURD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2724 DEER ST, MOHEGAN LAKE, NY 10547-2018
(347) 605-9048
Mailing address
2724 DEER ST, MOHEGAN LAKE, NY 10547-2018
(347) 605-9048
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2575558
NY
Other
Enumeration date
12/11/2015
Last updated
01/25/2016
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